"Build Better Bones": Development, Launch, and Future Directions of a Multilingual, User-Centered Website for Osteoporosis Management

Introduction: Osteoporosis is a common chronic disease that requires effective self-management, including optimal diet, exercise and home safety practices. The COVID-19 pandemic disrupted traditional outpatient care and increased the need for remote resources. In response, the International Osteoporosis Foundation (IOF) Rehabilitation Working Group developed a webbased platform "Build Better Bones" to support individuals with osteoporosis and their care providers. Methods: The website's development followed a design thinking, iterative process informed by input from diverse stakeholders, including patients, healthcare professionals, and design experts. Qualitative feedback from 24 stakeholders across three countries shaped the platform's usability and content. Key features include an evidence-based exercise library, practical nutritional guidance, and home safety recommendations. To ensure inclusivity, the site was designed to accommodate a global audience through translation into five languages and culturally diverse animated characters. Results: Stakeholders emphasized the primacy of site navigation and readability, empowering and inclusive images, and compassionate language. The website provides exercises tailored to the management of osteoporosis, focusing on exercise and nutrition with an emphasis on home safety to minimize the risk of fracture. The inclusion of interactive elements, multilingual support and visually appealing content was guided by stakeholder input. Patients identified the accordion-style presentation and focus on empowering self-management, while clinicians valued the evidence-based exercise recommendations. Qualitative input highlighted the need for inclusive language, accessibility improvements and practical guidance for safe practice at home. Conclusion: The "Build Better Bones" platform bridges a gap in osteoporosis care by providing evidence-based resources tailored to both clinicians and patients that can be disseminated to a global audience. Iterative stakeholder feedback has ensured that the platform is aligned with user needs, making it scalable and adaptable to real-world conditions. Future efforts will focus on expanding content, improving tailored features and integrating additional languages to serve a global audience. Mini abstract: The Build Better Bones website was developed using a robust stakeholderengaged approach to be a self-management resource for people with osteoporosis and for care partners of people with osteoporosis. The website focuses on providing education and resources for exercise, nutrition, home safety, and advice for care partners.