Objective To evaluate the effects of a re-fracture prevention and management program based on the Information-Motivation-Behavioral Skills (IMB) model in elderly patients with hip fragility fractures. Methods A non-synchronous class experimental research was designed. A convenience sample of elderly patients with hip fragility fractures was recruited from the orthopedics department of a grade A tertiary hospital. Forty-six patients hospitalized from March to July 2024 were assigned as a control group and received routine hip fracture care and discharge instructions. Another 46 patients hospitalized from August to December 2024 were regarded as an intervention group and additionally received the IMB model-based re-fracture prevention and management program. Results At 3 and 6 months after the surgery, the intervention group showed significantly higher scores than the control group in osteoporosis knowledge, self-efficacy, hip function, and medication adherence (all P<0.05), and the intervention effect, time effect and intervention×time interaction effect were statistically significant between the two groups (all P<0.05). The re-fracture incidence in the intervention group was lower than that in the control group, but the difference was not statistically significant (P>0.05). Conclusion The IMB model-based re-fracture prevention and management program can enhance osteoporosis knowledge in elderly patients with hip fragility fractures, improve their medication adherence, thereby promoting hip function recovery, and reducing the risk of re-fracture.