Global resource developed for osteoporosis self management

A new paper published in Osteoporosis International describes the rigorous, user-centered development of “Build Better Bones,” a multilingual website created to support self-management for people living with osteoporosis and their care partners. Developed by the International Osteoporosis Foundation (IOF) Rehabilitation Working Group, the project was initiated in response to a recognized global gap in accessible, high-quality self-management resources—particularly during the COVID-19 pandemic, when many individuals lost access to in-person rehabilitation services.

Professor Daniel Pinto, Lead Author and Co-Chair of the IOF Rehabilitation Working Group stated, “The Build Better Bones website was created to fill a vital gap in accessible, centralized osteoporosis resources. By combining input from a wide range of stakeholders, evidence-based guidance, and inclusive design, the platform supports both people with osteoporosis and their caregivers. Highlighting exercise, nutrition, and home safety, it encourages users to take an active role in maintaining bone health and preventing fractures.”

The development team adopted a design thinking and agile methodology to ensure the platform met real-world needs. The process included:

• Multidisciplinary collaboration among clinicians, researchers, communications specialists, and web designers
• Structured interviews and surveys with 24 stakeholders across the United States, Canada, and the United Kingdom
• Iterative usability testing to refine navigation, readability, tone, and visual presentation
• Evidence-based content development grounded in rehabilitation science and behavior change theory

A key innovation described in the paper, “Build Better Bones: development, launch, and future directions of a multilingual, user centered website for osteoporosis management,” is the structured approach used to select and present exercises. Rather than simply compiling a large database, the team conducted clinician interviews to identify meaningful patient characteristics guiding exercise prescription, developed clinical vignettes to simulate real-world decision-making, narrowed exercise options to reduce cognitive overload while maintaining safety and effectiveness, and created animated demonstrations reviewed by clinical experts to ensure proper form and clarity.

Stakeholder-driven refinement

Qualitative feedback shaped multiple aspects of the platform, including improved navigation tools and readability adjustments; more inclusive, empowering imagery; clear safety disclaimers; and compassionate language emphasizing “living with osteoporosis” rather than labeling users as patients.

The development team also incorporated dedicated sections on nutrition, home safety, and caregiver support, recognizing that effective osteoporosis management extends beyond exercise alone.

A scalable model for digital health information

“Build Better Bones” was designed not only as a website, but as a scalable global model for digital information and rehabilitation resources. From the outset, the platform was built for multilingual adaptation and cultural inclusivity, leading to its translation in five languages in 2023 (French, German, Portuguese, Russian and Spanish), and recently expanded to include Japanese.

The authors highlight future directions, including expanding exercise levels, broadening nutrition and caregiver resources, adding further languages, and formally evaluating usability and behavioral impact. By documenting the collaborative and theory-informed development process, the publication offers a roadmap for other organizations seeking to create accessible, evidence-based digital tools for chronic disease management.

Professor Olivier Bruyère, Co-author and Co-Chair of the IOF Rehabilitation Working Group, added, “Build Better Bones was created to give people with osteoporosis a trusted place to start. Osteoporosis management can be complex, and a diagnosis often feels overwhelming, but the right information and support can make a life-changing difference. The platform provides evidence-based guidance and practical resources that empower people to navigate their osteoporosis journey with confidence.”