Research programme
Bone-Health Assessment Programme
BHAT — Bone-Health Assessment Tool
A structured assessment that collects information about your health, lifestyle and medical history, to help understand bone health in Nigeria and support appropriate next steps.
BHAT is a bone-health assessment tool and does not replace professional clinical assessment or diagnosis.
At the end of the assessment you receive a provisional BHAT score from COBH's research scoring model, which uses FRAX, the established fracture-risk tool, as its scientific reference. COBH reviews the model after its initial three-month research period.
Who it is for
Designed for adults in Nigeria. You can complete it for yourself, or for another adult who has agreed to you giving their information.
What information is collected
Questions about your health, measurements, lifestyle, medical history and, if available, previous bone-density tests.
How it works
A step-by-step questionnaire that ends with your provisional BHAT score. Your answers are securely stored and used to support appropriate next steps and, if you agree, research.
Why it matters
It helps build a clearer understanding of bone health in Nigeria and contributes to developing a locally relevant assessment model.
What is BHAT?
BHAT is COBH's developing Bone-Health Assessment Tool. It asks about factors connected with bone health, including age and body measurements, past broken bones, medical conditions and medicines, lifestyle, falls, diet, and any bone-density test you have had.
FRAX is an established, validated fracture-risk assessment tool used internationally. COBH recognises its scientific value and uses it as the reference for developing BHAT. Our aim is to develop and evaluate a model informed by Nigerian data and context. We want to find out whether locally relevant factors and calibration can make the assessment more useful for people in Nigeria.
COBH's Community FRAX screening tool, available in English, Yorùbá, Igbo, Hausa and Nigerian Pidgin, remains available as a separate reference tool.
Valuable bone-health research already exists in Nigeria. BHAT adds a consistent, structured way of collecting information that answers COBH's research questions and supports future model development.
The BHAT scoring model is provisional and forms part of COBH's research programme. Following the initial three-month evaluation period, COBH will review the evidence collected to determine whether factors relevant to the Nigerian context materially affect the model and whether adjustments are required.
Current version and future model
- Now
- A structured assessment that calculates and shows your provisional BHAT score and category from COBH's current research scoring model, clearly labelled provisional, with a summary of your answers.
- After the initial three-month research period
- COBH re-evaluates the model and decides whether its inputs, weights or interpretation need to change. Results keep the model version that produced them.
- Longer term
- A model that may emerge after proper development, evaluation and validation in the Nigerian population. Until then, results need professional interpretation.
How it works
The intended pathway while the model is developed and evaluated, and where each stage stands today.
Complete BHAT
Answer the questions for yourself, or for someone who has agreed.
AvailableProvisional result
The system calculates your provisional BHAT score from COBH's current research model.
AvailableExplained within its limits
The result is explained in plain language, including what it doesn't mean.
AvailableProfessional review
Review or referral through the TOCAN network, following COBH's operational process.
Being set upResearch and evaluation
With your separate consent, de-identified findings help evaluate and improve the model.
Active
The scoring model is reviewed after the initial three-month research period. Over time, COBH will evaluate whether the model can give increasingly reliable support with less routine double-checking.
Who it is for
BHAT is being designed for adults. Final eligibility will be confirmed before it opens to real participants.
You can complete it for yourself, or for another adult, such as a parent or spouse, if they have agreed to you giving their information. Healthcare professionals can complete it for a patient or client when their service permits it.
It is not yet available for children. A child-appropriate consent and assent process has to be approved first.
What information is collected
- Age, sex, state and Local Government Area
- Weight and height. BMI is worked out for you
- Past broken bones and whether a hospital confirmed them
- Medical conditions and steroid medicines
- Smoking, alcohol and physical activity
- Falls, getting around and back pain
- How often you eat foods such as wàrà, fish, beans and ugu
- Any bone-density (DXA) test you have had
- Contact details, only if you ask COBH to follow up
Your name is not asked for.
Privacy, consent and research use
Separate choices
Taking part, storing your answers, research use and follow-up contact are each asked separately. Saying no to research or contact does not stop you completing the assessment.
Contact details kept apart
If you ask to be contacted, your phone number and email are stored separately from your answers and are never included in research data.
Why research use matters
If you agree, your de-identified answers and provisional result help COBH build the Nigerian dataset needed to evaluate and improve the model. Access is controlled and recorded.
Read the Privacy Notice and Research and Consent information.
Limitations
- BHAT is not yet a validated diagnostic tool or fracture-risk prediction tool.
- The provisional scoring model is being tested for the Nigerian context and will be re-evaluated after the initial three-month research period.
- The provisional result is not a diagnosis. It should be reviewed by an appropriate healthcare professional, usually together with a DXA bone-density scan where needed.
- Answers are self-reported and may be estimates.
- It does not replace professional medical advice or clinical judgement.
Next steps
Complete the assessment
Answer the questions as best you can. "Not sure" is always a valid answer.
View your provisional result
You'll see your provisional BHAT score and category, what contributed to it, and a summary of your answers.
Discuss with a professional
A trained professional in the TOCAN network will be able to review results and advise on next steps where appropriate. This service is being set up.
If you are worried about your bones, for example after a broken bone from a minor fall, please speak to a doctor or visit a health facility now.
Questions about BHAT
FRAX is an established, validated fracture-risk tool. COBH uses it as the scientific reference for developing BHAT. BHAT is COBH's own developing tool. It does not copy FRAX's model or produce a FRAX result.
COBH is studying whether a model informed by Nigerian data can be more useful for people in Nigeria. That has not yet been shown.
BHAT is currently being developed and evaluated as a Nigerian-context bone-health assessment. The current version calculates a provisional score using COBH's research scoring model. The model will be re-evaluated after the initial three-month research period to assess whether factors relevant to the Nigerian context require changes to the scoring approach.
The result is not a diagnosis and does not replace professional clinical review. It is not a probability of breaking a bone.
That is the intended pathway: review or referral through the TOCAN network of professionals. The TOCAN service is being set up; COBH will explain how to arrange a review once it is available.
Yes. Each section is saved when you continue. In the same browser tab you can pick up where you left off. To continue on another day, use "Save and finish later" in the assessment menu to get a resume code.
To support appropriate next steps for you and, if you agree, to build a consistent Nigerian dataset that COBH can use to develop and test a locally informed bone-health assessment model. Your answers count, including "not sure".
Choose "Not sure" or "I don't know". These are recorded as uncertain, never as "no" or zero, so please don't guess.
Yes. Your choice is recorded with its date. Contact COBH to change or withdraw it, as described in the Research and Consent information.
Your answers are stored securely, and access is limited to authorised COBH personnel according to their role, such as professionals involved in your review. Researchers only see de-identified data from people who agreed to research use. All access is recorded.
Ready to start?
The assessment takes most people around 10 to 15 minutes.