Rapid Improvement of Osteoporosis Cognitive Biases in Orthopaedic Inpatients Using Exposure-Based Multidimensional Education

<title>Abstract</title> <p> <bold>Background:</bold> Osteoporosis is a common skeletal disorder whose prevention and treatment depend heavily on patients' disease awareness. However, orthopaedic inpatients and their families frequently hold cognitive biases regarding osteoporosis, and conventional one-off health education models are insufficient to correct these biases during short hospital stays. This study aims to determine whether a multidimensional key-information reinforcement intervention based on the exposure effect theory can rapidly improve osteoporosis knowledge, health beliefs, and self-efficacy in this population. <bold>Methods:</bold> A randomised parallel-group controlled trial was conducted in two orthopaedic wards of a tertiary hospital in China from February 2026 to May 2026. Wards were randomly assigned by coin toss to the control group (n = 69) or the experimental group (n = 69). The control group received conventional health education. The experimental group received a three-day multidimensional intervention incorporating daily WeChat push notifications, colour-coded knowledge booklets with rotating themes, and verbal reinforcement by nurses three times daily. Outcomes were assessed using the Osteoporosis Knowledge Test, Osteoporosis Health Belief Scale, and Osteoporosis Self-Efficacy Scale at baseline, three days, and 30 days post-intervention. Repeated measures analysis of variance was used for between-group comparisons. <bold>Results:</bold> A total of 138 participants completed the study. Baseline characteristics were balanced between groups (P &gt; 0.05). Significant time-by-group interaction effects were found for knowledge scores (F = 265.350, P &lt; 0.001), self-efficacy scores (F = 126.678, P &lt; 0.001), and health belief scores (F = 456.981, P &lt; 0.001). At both three days and 30 days post-intervention, the experimental group scored significantly higher than the control group across all three measures (P &lt; 0.05). <bold>Conclusions: A</bold> multidimensional key-information reinforcement intervention based on the exposure effect can rapidly and effectively correct cognitive biases regarding osteoporosis among orthopaedic inpatients while simultaneously enhancing their health beliefs and self-management efficacy. This strategy offers a practical, low-cost approach to health education during short-term hospitalisation. <bold>Trial registration:</bold> Chinese Clinical Trial Registry, ChiCTR2600121564. Registered on April 1, 2026.Retrospectively registered. </p>