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Innovative approaches to driving public awareness of bone health

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In December 2012, Osteoporosis New Zealand (ONZ) published BoneCare 2020 which called for implementation of a systematic approach to hip fracture care and prevention for New Zealand. This included establishing a national hip fracture registry to benchmark care against quality standards and nationwide implementation of Fracture Liaison Services (FLS), to ensure all people who sustain fragility fractures receive guidelines-based care for the treatment of osteoporosis and falls prevention.

In 2016, the Accident Compensation Corporation (ACC, the Crown Entity responsible for injury prevention) made an investment of NZ$30.5 million (US$20 million) to support the registry, FLS, community and in-home strength and balances programmes, in addition to a range of other measures. With this progress achieved in the clinical realm, ONZ turned its attention to increasing awareness among the general public.

The first step was to develop a consumer-facing brand – Bone Health New Zealand (BHNZ) – which encourages people to be proactive in maintaining their bone health. BHNZ also addresses the common misperception that osteoporosis only affects elderly women and, therefore, is not relevant to other groups, including the initial target audience of women aged 45 to 60 years.

The second step was to work with our colleagues from Osteoporosis Australia to license a New Zealand version of the consumer-friendly Know your Bones tool. The tool had been developed and evaluated in a partnership between Osteoporosis Australia and the Garvan Institute for Medical Research in Sydney. Know your Bones™ provides a mechanism to engage an often disengaged audience, and for people who complete the online assessment, an individualised report to discuss with their physician.

In March 2020, BHNZ was launched with a digital engagement strategy through social media. During the first three weeks of the campaign, approximately 500 people completed the Know your Bones™ assessment, which exceeded industry benchmarks. BHNZ also served as a platform for the charity to engage with new corporate partners, to support plans for the campaign’s expansion. On March 25, on account of the COVID-19 outbreak, New Zealand went into Alert Level 4, putting the entire country into lockdown. Plans for engagement with new corporate partners were put on hold.

In June 2020, a grant from Mediaworks NZ – a television, radio and interactive media company – provided an opportunity to promote the BHNZ campaign with a television commercial (TVC) that would air for two weeks on NZ TV3. A 30 second TVC was produced, which can be viewed on YouTube. The TVC encouraged viewers to head to www.bones.org.nz to complete the Know your Bones assessment. A still image of the TVC was also displayed on three digital billboards in prominent locations in Auckland.

During the two-week period that the TVC aired, 5,000 people completed the Know your Bones™ assessment. This dramatically exceeded the ONZ team’s expectations and illustrates that a very simple message, combined with a clear call-to-action, can engage members of the public in an unprecedented fashion.

ONZ is currently working to engage new corporate partners and government agencies to broaden the BHNZ campaign to target all New Zealanders aged 50 years or over who have sustained a fragility fracture. In due course, and with adequate resource, the intention would be to expand this to the entire population aged 50 years or over. If the majority of the 1.6 million people in this age group were to undertake the online assessment, New Zealanders certainly would Know their Bones!

ONZ wishes to acknowledge the support of ACC, which enabled licensing of Know your Bones™ from Osteoporosis Australia. Furthermore, very generous pro-bono support from ONZ’s agency, Deep Ltd, in combination with colleagues at The Rig and Factory Studios, made it possible to produce the TVC at a fraction of standard costs.

Paul Mitchell, Osteoporosis New Zealand, University of Notre Dame Australia, University of Oxford

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