Define bone health throughout the life span and elevate bone health to the level of other common health concerns

Understand the different aspects of bone health in different groups

Identify lifestyle issues universally applicable to bone health (e.g., smoking, exercise, calcium, nutrition)

Develop both general and targeted messages for osteoporosis and other bone diseases that engage listeners (e.g., through an emotional hook)

Bring together different perspectives to guide the development and delivery of messages

Make development of a cohesive message on healthy lifestyles a key objective of Healthy People 2020

Develop ways to evaluate messages’ effectiveness and to refine as required

Promote healthy lifestyles through point-of-decision prompts (e.g., to use the stairs rather than the elevator)

Develop a national speaker's bureau to disseminate information about bone health and bone disease to health professionals

Link osteoporosis to issues raised in the Institute of Medicine report on ethnic disparities in health and to the need to develop osteoporosis programs in community health centers

Develop a modifiable web-based educational tool on bone health from which people can select appropriate levels of information about bone diseases

Create a National Bone Education Campaign and identify celebrity spokespersons (e.g., public officials, actors) to deliver messages

Create a clearinghouse for existing educational material

Create a brand identity, such as a logo that is a visual cue for bone health

Work with the media

Develop standards of care for diagnosis and treatment of bone diseases (including for special populations such as children, the disabled, and non-Caucasian men and women) and build public awareness around these standards

Make standard care available to all who need it, which will require adequate local resources, reimbursement, and commitment

Promote programs sponsored by pharmaceutical companies that make drugs available to low-income individuals

Develop less costly treatments and supplements

Offer better financing of clinical services

Increase availability of mobile DXA

Develop tools for volunteers and advocates to take action in local communities

Encourage schools and work sites to make healthy food available

Promote activity through accessible and safe indoor and outdoor space (e.g., trails, walkways, stairs)

Develop multidisciplinary centers that house all aspects of bone health under one roof, including bone density screening, physical therapy, and other services

Publish best practices in community interventions

Engage policymakers in discussions of local needs

Issue a call for inclusion of information about bone health in the curricula of health professionals

Define basic competencies for all health professionals for the prevention and treatment of osteoporosis and other bone diseases

Develop a tiered approach to training health professionals about bone health (e.g., use curriculum “bytes” that are appropriate at various levels of education)

Develop nutrition and exercise guidelines, curricula, and messages that are gender, age, and culturally appropriate

Engage patients in the health care decision-making process around bone health

Develop multidisciplinary, evidence-based protocols to promote bone health and identify and treat patients with bone disease

Develop a simple uniform policy for the treatment of bone disease

Identify relevant system components for quality bone health care, including the role of physicians, nurses, and physical therapists

Identify and promote community best practices

Expand nutritional labeling to restaurants

Develop national practice guidelines to assist in the implementation of state-level quality-of-care programs

Implement performance measures (e.g., HEDIS) to evaluate quality of care of bone diseases

Develop collaborative public-private partnerships to fund research, education, and interventions, and to promote access to policymakers

Develop a committee of health professional organizations to identify clinical practice priorities and specific treatment objectives for bone disease

Collaborate with non-medical community entities (e.g., churches and senior centers) to provide consistent information about prevention and treatment of bone disease

Partner with the food industry on initiatives to improve bone health (e.g., approach fast food restaurants about changing the standard drink in children's meals from soda to milk, work with grocery stores to put signs in the dairy section saying “stop here for bone health”)

Create interdisciplinary networks to shape an educational and research agenda

Develop a better understanding of the mechanisms that lead to osteoporosis, with an eye toward early interventions (e.g., for pre-menopausal women)

Strive to alter the pathophysiology of diseases such as Osteogenesis Imperfecta and fibrous dysplasia

Conduct further research into restorative therapies and innovative therapeutic strategies (e.g., combination therapies, sequencing of therapies, appropriate duration)

Increase research on medical and behavioral interventions and outcomes among specific populations including providers

Evaluate data on positive and negative messages to determine what effect they have on behavior change

Define optimal nutrition and exercise prescriptions

Increase research on physical activity strategies for special needs populations

Increase epidemiological research

Develop methods to better track trends in data on bone health

Collect data about bone health on diverse populations to guide treatment practices

Improve reporting of fracture incidence and develop a state and local public health fracture surveillance network across age spans

Develop outcome measures as a database for messages to policymakers

Increase the focus on the development of standardized, measurable objectives to achieve better bone health

Increase funding for national and state partnerships and prevention programs to promote healthy lifestyles and to expand education and outreach programs

Have public and private payers offer separate coverage for screening and adjust codes so that they are more consistent in their coverage of screening tests

Increase funding for research to inform innovative programs