Osteoporosis Awareness - "Request the Test"

1. NBHA:
NOF:
HOLOGIC
–
Osteoporosis
Awareness
Campaign
1
National Bone Health Alliance – NOF – Hologic
May 16, 2013
Osteoporosis Awareness and DXA Testing
William Clarke, Hologic, Inc. Sr. Marketing Manager - Corporate Liaison

2. NBHA:
NOF:
HOLOGIC
–
Osteoporosis
Awareness
Campaign
2
Overview: Osteoporosis Awareness and DXA Testing Initiatives
The stark reality of osteoporosis, along with its crippling effects on the human body, somehow
fails to excite the medical community or strike fear within the souls of the masses. People, in
general, along with many primary care physicians, fail to realize the enormity and impending
threat of this disease. They are oblivious to the simplistic signs and symptoms that can ultimately
link this disease to nearly anyone who is beyond midlife in age, those over fifty who have
suffered a fracture, and even people younger in age who’s bone mass is dwindling away due to
drug-induced osteoporosis. Osteoporosis, fittingly enough, is referred to as the silent killer,
stealing your freedom, vanquishing your mobility and eventually, ending your life.
Perception is everything. When someone mentions cancer, suddenly there is muddled silence,
uneasy feelings and an ever-present fear. When a reference is made to osteoporosis, there is an
indecisive, “what is that”? An incredulous ignorance of this disease permeates society and the
devastating effects it bestows upon the body. This is another great example of what you don’t
know, will most likely kill you. Surprisingly enough, more people will die from osteoporosis this
year than both breast and prostate cancer combined.
Although more than 10 million Americans are stricken with osteoporosis, there are nearly 35
million others who have low bone mass (osteopenia) which is a precursor to developing the
disease. Physicians agree that osteoporosis is not only under diagnosed but also under treated.
Those who are at risk fail to get referred for a 15-second DXA test. Simple DXA testing can
establish the risk potential before the fracture ever occurs, yet only about 32% of those who could
be tested are currently receiving DXA exams. In many instances, even after the patient suffers a
low impact fracture (non-traumatic) which is a clear indicator of the disease, the patient still goes
untested (Boyd, 2011). DXA is a diagnostic exam (low dose x-ray) utilized to diagnose

3. NBHA:
NOF:
HOLOGIC
–
Osteoporosis
Awareness
Campaign
3
osteoporosis; the hip and spine are the critical areas assessed. Once the data is acquired from the
patient, the information regarding bone density is expressed in statistical scores, T-scores and Z-
scores, which place patients in specific classifications indicated as normal, osteopenia, and
osteoporotic.
Factors Influencing the Issue
Osteoporosis appears to be surrounded by a shroud of ignorance and lack of education, for both
patients and their physicians. The general population must become empowered with regard to
bone health, and they must be educated on the risks that are involved with osteoporosis. While
physicians need to be well aware of the symptoms and risk factors involved with the disease, they
must be aggressive and test patients before the fracture occurs which will allow for expedited
treatment planning and improved patient outcomes.
Both private payers and Medicare cover DXA bone density testing, with the average
reimbursement of about $60 (CMS, 2013) nationally. Only five years ago, reimbursement was
averaging about $150 per scan and physicians were more willing to offer DXA in their office. As
reimbursement dissipated drastically, physicians have become less likely to purchase the
Hologic
DXA
system
2013,
standard
bone
density
assessment
package.

4. NBHA:
NOF:
HOLOGIC
–
Osteoporosis
Awareness
Campaign
4
equipment, so in turn there is a lack of access for patients. Testing will usually be permitted by
CMS every other year, unless the patient is on Bisphosphonate therapy. Bisphosphonates are the
class of drugs that rebuild and fortify bones (Fosamax, Boniva, Actonel, and Reclast) and prevent
further bone loss. While being treated with Bisphosphonates, patients are allowed more frequent
DXA exams enabling clinicians to track the drug’s effectiveness.
Ultimately, ignorance and a lack of urgency have pushed osteoporosis to the bottom of the list
with regard to healthcare relevance or priority. Medical professionals continue to look the other
way, fail to educate, improperly diagnose, or have just avoided the establishment of guidelines
that will improve testing practices. In retrospect, it is the patient that suffers and does not receive
the appropriate DXA testing when it should be common clinical practice. Although in reality
patients can request the exam, but it must be ordered - prescribed by a physician. When at risk
osteoporosis patients move through the system untested, they eventually succumb to fractures,
unnecessary pain, debilitation, and eventually death.
DXA
exam
of
the
hip
and
spine.

5. NBHA:
NOF:
HOLOGIC
–
Osteoporosis
Awareness
Campaign
5
Goals and Objectives of the Campaign:
Goal: Increase the number of adults receiving DXA testing for osteoporosis evaluation.
S.M.A.R.T Objective: Within 5 years, by the end of 2018, increase the number of adults by
50%, 40 years of age or older, who are tested and evaluated with DXA bone density systems.
Target Audience
Our target audience is men and women age 40 and older, Caucasian, fair skinned and very likely
of European, Hispanic, or Asian descent. These specific cultural and ethnic groups are highly
susceptible to osteoporosis. They speak English, Spanish, and Japanese, while they may also
speak, read, and write one or more other languages. More than 50% are retired baby boomers,
while the majority of the remaining demographic is married, lower-middle to upper-middle class,
and they visit their physician for annual check-ups. They are educated, fairly well read and
engaged in current events and the nightly news (Lavelle, 2004).
They are at risk for osteoporosis due to their ethnic background, fail to eat right all the time, may
be calcium deficient, and taking a prescribed drug for gastric reflux or anxiety, which also causes
bone loss. They drink alcohol occasionally, don’t get enough sleep, fail to exercise regularly and
more often than not, find themselves stressed.

6. NBHA:
NOF:
HOLOGIC
–
Osteoporosis
Awareness
Campaign
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Primarily, our intended audience is aging baby boomers and bone loss is a fact of life. They are
uniquely susceptible and highly likely to become victims of osteoporosis.
Marketing Channel Strategies
The Health Belief Model is relative to the interpersonal / individual level theory, the assumption
here is that people will change their prospective attitude if they feel at risk. They must believe
that the risk of the threat can be overcome with a change in behavior. Overall, the belief must be
relative to behavior changes and the costs of those changes, while true benefits of the change,
must exceed the cost. Below are the six factors relative to the health belief model for the
prospective program.
Osteoporosis Awareness and DXA Testing:
1. Perceived susceptibility - present people of the perspective age groups, ethnicities, and
demographic discussing osteoporosis. (TV)
2. Perceived severity - deliver statistical data on deaths from osteoporosis through a video
format with actual severely stricken patients. (TV)
3. Perceived benefits - present the option of DXA testing and the proper medication
alleviating the risk factors. (TV, radio, web banners)
4. Perceived barriers - design messaging that will glorify the behavior change, centered
around, happy, healthy, longer lives. (TV, radio, YouTube)
5. Cue’s to action - we will develop our campaign with the intent that husbands and wives
get tested together, public service announcements. (Direct mail-Posters)

7. NBHA:
NOF:
HOLOGIC
–
Osteoporosis
Awareness
Campaign
7
6. Self-efficacy - convince the audience the simplistic nature of the behavior. (Social media,
YouTube)
Our primary objective is the baby boomer generation as they may be the only remaining segment
of the population that actually reads the newspaper, watches hours and hours of television, and
are responsible for 40% of the entire consumer demand in the country today. Baby boomers have
also become quite tech savvy, they utilize the web, social media, and they understand the nuances
of the digital age.
The strategy will be an integrated approach, utilizing a specific blend of media. Our direct mail
and poster campaign will host the same colors and styles, as we would like our audience to easily
recognize the messaging. The television and radio commercials will have the same voice-over
personality and the same actors will be shown in each production. The statistics utilized will be
identical regardless of format or medium, always delivering the same exact message. We will
align and brand our program with the intent to create an atmosphere for osteoporosis awareness.
Message and Promotional Strategy
The osteoporosis and DXA testing awareness campaign “Request-the-Test”, attempts to secure
the attention of baby boomers nationwide. “Request-the-Test” plans an onslaught of television,
radio, social media, and direct mail to spoon feed its message to the intended audience. While
hospitals, clinics, and primary care physicians will be displaying numerous posters, cards, and
calendars with the message, “Request-the-Test”. This unique alliance between the campaign and
medical practitioners is designed to inform patients and encourage testing. While also directing

8. NBHA:
NOF:
HOLOGIC
–
Osteoporosis
Awareness
Campaign
8
them toward the toll free number (800-DXA-TEST) for more information, and the website
(www.GetTested.com/DXA) where they will directed to an osteoporosis center for DXA testing.
Ideally the campaign is designed to introduce the severe risks of osteoporosis to the patient
population who are most threatened. The campaign seeks to offer clinical information that will
support the claim, such as this statistic that “one out of every two women over the age of 50 will
suffer a fracture related to osteoporosis” (NOF.org, 2013). This is truly an emotional plea that the
campaign would like to deliver to each and every patient’s living room. The idea is to create a
sense of urgency, convince those at risk that if they “Request-the-Test”, a simple 15-second test
may change their lives forever. Patients who are tested and diagnosed with early onset
osteoporosis can be successfully treated, treatment (Pharmaceutical-Biologics) helps them
maintain independence, mobility, and overall health. The campaign is loss framed with the intent
to illicit fear of the disease and its crippling effects, while also impressing upon them (patients)
the potential risk of death.
The campaign will evaluate phase one of the media blitz by evaluating the increase in the number
of DXA screening within the regions surveyed. A key deliverable would an increase in the overall
number of exams compared to the average numbers for that particular timeframe the previous
Before
you
lose
it
for
good…
Request-­‐the-­‐Test!
1-­‐800-­‐DXA-­‐TEST

9. NBHA:
NOF:
HOLOGIC
–
Osteoporosis
Awareness
Campaign
9
year. Process measures will be reviewed as well, the number of calls received during the media
campaign to 800-DXA-TEST. The website (SEO and SEM fortified) will be monitored as well
(Google analytics), how many hits on a daily, weekly, and monthly perspective, as well as the
number of patient information download. Email requests for information, with regard to
osteoporosis clinics, physicians, and general osteoporosis information will be assessed. The
campaigns two videos, “Get Tested Today!” and “Ask Your Doctor About DXA”, both available
on YouTube, will be tracked for downloads and overall consumer interest.
When the numbers from each outlet are determined the “Request-the-Test” team will evaluate
each option, and make changes and adjustments as needed. If necessary, resources will then be
reallocated toward different outlets to better serve the campaign or new media sources may be
utilized to enhance the message.
Implementation
The distribution plan is tied to their “Request-the-Test” packets, which will be sent on May 31,
2013, the packets will be sent to 150 hospitals, clinics, and primary physician offices throughout
the United States. The packet contains posters, videos, appointment cards, calendars, and stickers
all focused on osteoporosis awareness and the campaign “Request-the-Test”. The kits contents
will be distributed once, this one time printing was provided free of charge. There will be a CD in
each packet with PDF versions of the printed collateral, which will allow users to create or print
more material as needed. The PDF’s will also be available on the website, and through the
campaigns partner organizations, National Osteoporosis Foundation, National Bone Health
Alliance, Hologic, American College of Rheumatology, and The Bone and Joint Initiative.

10. NBHA:
NOF:
HOLOGIC
–
Osteoporosis
Awareness
Campaign
10
Hill Holiday of Boston will be providing pro bono PR and marketing communications consulting
for the campaign. Hill Holiday is one of the top agencies in the country, and they will with
campaign development, planning, and organization. Beginning with the press release to all media
outlets, and then followed up with the introduction of the campaign video “Get Tested Today”,
which will presented every other hour for the entire day on the Time Square jumbo screen.
The campaign has been guaranteed funding from several sources, corporate sources and DXA
manufacturers General Electric and Hologic, along with a National Institute of Health grant and a
grant from the Getty Health Foundation. ”Request-the-Test” will also attempt to raise funds
through the website www.GETTESTED.COM and the toll free hotline 800-DXA-TEST.
If funding is maintained, this campaign can make a difference with regard to osteoporosis
awareness while increasing DXA testing. “Request-the-Test” has the ingredients for success,
possessing strong messaging, for a cause that is undeniable.

11. NBHA:
NOF:
HOLOGIC
–
Osteoporosis
Awareness
Campaign
11
Reference
Western Washington University (2013) Center for healthy living-Demographics, Retrieved from:
http://www.wwu.edu/healthyliving/education/osteoporosis/demographics.shtml
Brody, J (2011) A Reminder on Maintaining Bone Health, Retrieved from:
http://www.nytimes.com/2011/11/01/health/a-reminder-on-bone-health-and-osteoporosis.html
Goldstein, S (2011) What is the optimal interval for osteoporosis screening in postmenopausal
women before fracture occurrence and osteoporosis treatment initiation, Retrieved from:
http://www.obgmanagement.com/article_pages.asp?AID=10653
AAOS (2013) Osteoporosis and Bone Health, Retrieved from:
http://www.aaos.org/news/aaosnow/may09/clinical8.asp
Lavelle, P (2004) Osteoporosis, Retrieved from:
http://www.abc.net.au/health/library/stories/2004/04/29/1831468.htm#.UYhyJr_Q50o
WVU IMC PI Reed School of Journalism (2013) Lesson 2 – Theory Review of Health Behavior
Change, Retrieved from:
https://ecampus.wvu.edu/webct/urw/tp0.lc5116001/cobaltMainFrame.dowebct
WVU IMC PI Reed School of Journalism (2013) Lesson 7 – Selecting Health Message Channels,
Retrieved from: https://ecampus.wvu.edu/webct/urw/tp0.lc5116001/cobaltMainFrame.dowebct
Baby
Boomer-­‐Magazine.com
(2013)
Who
are
the
baby
boomers,
Retrieved
from:
http://www.babyboomer-­‐magazine.com
WVU IMC PI Reed School of Journalism (2013) Lesson 6 – Developing Health Messages,
Retrieved from: https://ecampus.wvu.edu/webct/urw/tp0.lc5116001/cobaltMainFrame.dowebct
WVU IMC PI Reed School of Journalism (2013) Lesson 9– Implementing Health Campaigns,
Retrieved from: https://ecampus.wvu.edu/webct/urw/tp0.lc5116001/cobaltMainFrame.dowebct
WVU IMC PI Reed School of Journalism (2013) Lesson 8 – Evaluating Health Campaigns,
Retrieved from: https://ecampus.wvu.edu/webct/urw/tp0.lc5116001/cobaltMainFrame.dowebct