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PB&J (Protect Your Bones and Joints) is a program of the United States Bone and Joint Initiative (USBJI) designed to educate high school-age students about musculoskeletal conditions and encourage them to learn about prevention activities. The program was initially developed by Michael DeFranco, MD, an orthopaedic surgery resident at The Cleveland Clinic, and has since been added to by many educators and other health care professionals representing the diversity of those concerned with bone and joint disorders.

Offered nationwide, even internationally, the program was launched as a pilot project for the Bone and Joint Decade's National Action Week in October 2004. Results from the pilot activity, in which more than 1,000 student freshmen at six high schools in Cleveland, Ohio, received the program, were most promising.

Dr. DeFranco, keenly interested in addressing the impact of musculoskeletal diseases, believed a significant contribution to reducing the future burden, could be obtained by raising awareness among the young. Discussing his ideas with Edward Benzel, MD, a neurosurgeon at the Cleveland Clinic, and also a Bone and Joint Decade ambassador, they realized that the Decade, now called the Bone and Joint Initiative, provided an ideal potential host organization. The Initiative, a network of around 100 organizations, had already been discussing how to reach the adolescent market as a means to address the future burden of disease. They found the Initiative most receptive, and so PB&J (Protect Your Bones and Joints) was developed.

"Acquiring knowledge about bone and joint disorders at a young age will allow individuals to mature into adults being mindful of the activities that will prevent musculoskeletal disease and keep them active through their golden years," says Dr. DeFranco.

The pilot program was presented at Collinwood, Glenville, Lincoln-West and Martin Luther King public schools, and private high schools St. Ignatius and Magnificat.

The advantages of this program are many. First of all, it is an opportunity for health care professionals as well as medical students, residents and fellows, nurses, physical therapists, and athletic trainers to become involved in USBJI. Their active participation not only stresses the importance of the Initiative, but also allows them to share their professional knowledge and skills with the community.

Secondly, the target of the program is a population of young people that will benefit from learning about musculoskeletal injuries and disease. The knowledge they gain through the program will allow them to lead lifestyles that protect their bones and joints. The high school students are able to share their understanding of musculoskeletal problems and prevention of them with their families. In fact 81.5% of students who received the pilot program thought the material was important to learn and to share with their families. 

"By the end of the course 82% of students were able to correctly define arthritis, and 86.5% osteoporosis. 87.2% of students strongly agreed the program should be given to future students," reports David Joyce, MD, Case Western Reserve University, and leader of the volunteer team that presented the program.

This information can be used to improve and tailor future educational programs. Overall, the project achieves one of the primary goals of the U. S. Bone and Joint Initiative: awareness and prevention through education.

Following assessment of the pilot launch in Cleveland, a task force of healthcare professionals representing several disciplines involved in the Initiative reviewed and expanded the pilot program in preparation for it to be offered nationwide. In October 2005 the program, was recognized by the state of Kansas as the best of its kind that year.