Osteoporosis Preventive Behavior Among Female Healthcare Students in Da Nang, Vietnam

Background: Osteoporosis prevention at young ages is crucial to diminish the risk of the disease and its complication in later years of life. Having good osteoporosis knowledge and positive health belief may lead to better preventive behavior which then contributes to build and maintain bone health throughout life. Objective: To investigate knowledge, health belief, and behavior of osteoporosis prevention among female healthcare students. Methods: The descriptive cross-sectional study was conducted in a public medical university in Da Nang of Vietnam. Four hundred participants were selected by applying the multistage sampling technique. Data were collected from May 2020 to June 2020 through the questionnaire that consists of 4 parts including the demographic data form, the osteoporosis knowledge assessment tool, the osteoporosis health belief scale, and the exercise and calcium behaviors scale. Data were analyzed using descriptive statistics and Pearson correlation test. Results: Participants had poor osteoporosis knowledge (mean [SD], 37.8 [16.0]; range, 0 - 75) and low preventive behavior (mean [SD], 5.7 [3.5]; range, 0 - 25). Osteoporosis health belief was found at a moderate level with a mean (SD) of 126.7 (12.9) (range, 84 - 187). There were positive significant correlations between knowledge and health belief, knowledge and behavior of osteoporosis prevention (P < .05). Conclusions: Osteoporosis preventive behavior of female healthcare students was low. Osteoporosis education programs should be developed for female healthcare students to improve their knowledge and health belief that would then lead to their better preventive behavior.

Az Osteoporosis Health Belief Scale kérdőív magyar nyelvű validálása

Összefoglaló. Bevezetés: A nemzetközi szakirodalomban számos betegséget illetően elérhető betegségspecifikus tudást és attitűdöt mérő kérdőív. Magyarországon az osteoporosis témakörében validált kérdőívek tárháza meglehetősen hiányos. Célkitűzés: Célunk volt a csontritkulás-specifikus magatartás és attitűd vizsgálatára alkalmas Osteoporosis Health Belief Scale (OHBS-) kérdőív magyar nyelvre történő validációja, melynek segítségével mérhetővé válna a magyar anyanyelvű nők csontritkulással kapcsolatos attitűdje. Módszer: A kérdőív magyar nyelvre validálása a 2000-ben megfogalmazott hatlépcsős irányelv szerint történt. A külső validitás vizsgálatához az Osteoporosis Knowledge Assessment Tool (OKAT-) kérdőívet használtuk. Mintánkat 600 fő alkotta; statisztikai számításaink során leíró statisztikát készítettünk, különbözőségi vizsgálatokat végeztünk, a belső konzisztencia vizsgálatára Cronbach-alfa-értéket számítottunk, a konvergens validitás és a teszt-reteszt mérések vizsgálatához Spearman-féle korrelációs koefficienst számítottunk. A kérdőív belső struktúrájának vizsgálatához faktorelemzést végeztünk. Ennek megfelelően Kaiser–Meyer–Olkin (KMO)-tesztet és Bartlett-próbát számítottunk. Eredmények: Mintánk (37,7 ± 13,15 életév) az OHBS (126,28 ± 14,85 pont) és az OKAT (8,78 ± 3,1) tekintetében egyaránt alacsony pontszámot ért el. A teljes kérdőívre kivetített Cronbach-alfa-érték 0,802 volt. A faktorelemzés (KMO = 0,886; Bartlett-próba p<0,001) 7 faktort különített el, melyek megfeleltethetők az eredeti faktoroknak. A teszt-reteszt során a Spearman-féle korrelációs koefficiens 0,921 és 1,000 közötti értéket mutatott. Az OKAT- és az OHBS-dimenziók összevetésekor számos szignifikáns kapcsolatot találtunk. Megbeszélés: A vizsgálati eredmények megfelelnek az eredeti kérdőív szerinti, továbbá a más nyelvre történt validálás során kapott eredményeknek. Következtetés: Eredményeink alapján a magyar nyelvű OHBS csontritkulás-specifikus attitűdöt és magatartást vizsgáló kérdőívet megbízható és valid kérdőívnek tartjuk. Orv Hetil. 2021; 162(37): 1494–1501. Summary. Introduction: In the international literature, several disease-specific questionnaires are available for many diseases. The opportunities of validated questionnaires are incomplete about osteoporosis in Hungarian language. Objective: The aim of the study was to validate the Osteoporosis Health Belief Scale (OHBS) into Hungarian that would make it possible to measure the osteoporosis-related attitude for Hungarian-speaking women. Method: The questionnaire was validated into Hungarian according to the six-step guideline outlined in 2000. The Osteoporosis Knowledge Assessment Tool (OKAT) questionnaire was used to examine external validity. Our sample consisted of 600 women. We performed descriptive statistics; Cronbach’s alpha value was calculated for internal consistency, we calculated Spearman’s correlation coefficient to examine external validity. We carried out factor analysis (Kaiser–Meyer–Olkin [KMO] test, Bartlett test) to examine whether the new questionnaire is suitable for measurements in the given language the same way as the original questionnaire. Results: Our sample (37.7 ± 13.15 years of age) achieved low score for both OHBS (126.28 ± 14.85) and OKAT (8.78 ± 3.1). The Cronbach’s alpha value was 0.802. Factor analysis (KMO = 0.886; Bartlett test p<0.001) identified 7 factors that can be similar to the original factors. During the test-retest, the Spearman correlation coefficient showed a value between 0.921 and 1.000. When comparing the OKAT and OHBS dimensions we found several significant relationships. Discussion: The results of the study are similar to the results of the original questionnaire validation as well as to other OHBS validation studies. Conclusion: Based on the results, we consider that the Hungarian form of the OHBS is a reliable and valid questionnaire. Orv Hetil. 2021; 162(37): 1494–1501.

Pregnancy Associated Osteoporosis: Knowledge Attitude and Practice of Exercise among Pregnant Women in a Selected Nigerian Community

Pregnancy induced decrease in bone mineral density (BMD) often occurs at the femoral necks, lumbar spine and other sites during the second or third trimester of pregnancy leading to pain in the hips, pelvis, low back etc and sometimes fractures even with mild trauma/falls. Exercising during pregnancy has been known to offer several benefits including improving bone health. However, there is paucity of studies investigating the knowledge, attitude and practice of pregnant women towards exercising to minimize the risk for osteoporosis. The aim of this study was to investigate the knowledge, attitude and practice (KAP) of exercise for the prevention of pregnancy associated osteoporosis among urban and rural dwelling pregnant women in a selected Nigerian community. A total of 258 (168 urban dwelling and 90 rural dwelling) pregnant women were recruited and subjected to interview using a pre-validated questionnaire on KAP of exercise in the prevention of Pregnancy associated osteoporosis. The urban and rural dwelling women had moderate and poor knowledge of exercising for osteoporosis prevention respectively. Both groups of women had moderately positive attitude towards exercising for osteoporosis prevention. Also both groups of women had poor practice towards exercising for osteoporosis prevention. A significant association was only found between having another source of income in the family and the women’s attitude towards exercise.

The association of osteoporosis knowledge and beliefs with preventive behaviors in postmenopausal breast cancer survivors

Background Postmenopausal breast cancer survivors (PBCS) are at increased risk of bone loss and fractures due to age-related decline of estrogen, and this risk is compounded by aromatase inhibitor cancer therapy. Several patient-level targetable risk factors can mitigate osteoporosis risk; however, adequate health behavior and risk perception in this population are underreported. The goal of this study was to evaluate osteoporosis knowledge and beliefs and assess their association with engagement in osteoporosis preventive behaviors among PBCS. Methods In this cross-sectional descriptive study, early stage I–IIIA PBCS (ages 55–86 years) completed the Facts on Osteoporosis Quiz, Osteoporosis Health Beliefs Scale, and Osteoporosis Preventive Behaviors questionnaires. Participants who were non-English speaking or declined to participate were excluded. Clinical and sociodemographic information were obtained from chart review and baseline questionnaire, respectively. Fisher’s exact test, Student t-test, and Wilcoxon Mann–Whitney tests were used where appropriate to assess the association between knowledge and beliefs with engagement in osteoporosis preventive behaviors. Results The mean participant age was 66.1 years with 20% self-reporting as non-Hispanic White, 40% non-Hispanic Black, 27% Hispanic, and 13% other. Approximately 83% of the cohort had estrogen receptor positive breast cancer and received a bone density scan within the last six years. Osteoporosis knowledge (10.5 ± 3.4), seriousness (14.9 ± 3.8), and susceptibility (14.0 ± 3.5) mean scores were low among PBCS. Most PBCS (75%) were adherent to calcium and vitamin D supplements, but only 47% reported engagement in strength-training exercises. Married/partnered, higher osteoporosis knowledge and health motivation scores were associated with strength-training exercise. After adjustment for marital status and osteoporosis knowledge, only health motivation score remained significantly associated with strength-training exercise (OR 5.56, 95% CI 1.35–22.93). Conclusions PBCS are highly motivated to keep a healthy lifestyle despite limited osteoporosis knowledge, perceived risk, and susceptibility. However, < 50% participated in strength-training exercise. Our findings suggest that oncologic care should include osteoporosis and fracture prevention strategies, directed at encouraging cancer survivors to increase their engagement in osteoporosis preventive behaviors, particularly strength-training exercises.

Knowledge, awareness, and preventive behaviors toward osteoporosis among a sample of premenopausal women in Erbil city, Iraq

Background and objective: Osteoporosis is among the top five conditions causing disability and prolonged hospital stay; however, it is still underestimated worldwide, especially in developing countries. Therefore, this study aimed to determine the knowledge, attitude, and preventive practice in Erbil city toward this global disease. Methods: A cross-sectional study was conducted among 395 premenopausal women aged ≥25 years and ≤ 49 years old, who were recruited by simple random sampling throughout three months from the first of October to December 2015. A questionnaire was completed through a direct interview, which consisted of four parts, including questions about knowledge, attitude, practice, and demographic questions. The statistical package for the social sciences was used for data analysis. Results: The mean age of the participants was 35 ± 8.24 years. Almost half of them did not hear about osteoporosis before. The identification of risk factors by participants was poor. Out of 395 of the participants, 92.9% had no knowledge about the diagnosis of this disease. Approximately half of the participants believed that there is no way to prevent osteoporosis. Regarding practice scoring to prevent the disease, the total score (mean) was 2.9 out of a maximum of 12, which is very low, especially among females aged 25-29 years. Conclusion: The majority of premenopausal women in Erbil city had little knowledge of osteoporosis, however unaware of osteoporosis risk factors and poor preventive practice regarding prevention. Keywords: Osteoporosis; Knowledge; Premenopause; Disability; Iraq.

The development of a reliable and valid instrument to measure the osteoporosis-related knowledge: validation of the Hungarian version of Osteoporosis Knowledge Assessment Tool (OKAT)

Background Osteoporosis is one of the most common chronic musculoskeletal diseases. Osteoporosis-related knowledge is an important contributor in to prevent osteoporosis. There is no validated reliable questionnaire to measure the knowledge in Hungary. The aim of the study was to validate the Osteoporosis Knowledge Assessment Tool (OKAT) Hungarian version. Methods The research was a randomized validation study of a new Hungarian language instrument. The questionnaire was administered to 557 randomly selected healthy women (age between 25 and 44 years) from December 2018 to July 2019 in Baranya county, Hungary. The reliability was examined by the Flesch reading ease and McNemar’s test. We examined item discrimination and item-total correlations, inter-item consistency (Cronbach’s alpha coefficient) and principal component factor analysis. Results Significant differences (p < 0.001) were reported between total scores and the age categories. Significant (p < 0.001) correlation (r = 0.25) was found between the education level and the knowledge. Significantly (p < 0.001) higher knowledge were found in health care profession (14.53 ± 3.58) than the non-health care profession (9.99 ± 4.04). Participants with osteoporosis or fracture in family history had better knowledge (p < 0.001). Flesch reading ease was 44, the questionnaire had a Ferguson’s sigma of 0.94 and a Cronbach’s alpha of 0.81. There were no negative inter-item correlations psychometric properties of the OKAT, all items had more than 70% of correlations (p < 0.001). Conclusions The Hungarian version of the Osteoporosis Knowledge Assessment Tool is a reliable and objective questionnaire to measure women’s knowledge in Hungary.

Osteoporosis Knowledge, Beliefs, and Preventive Behaviors in Postmenopausal Breast Cancer Survivors

BackgroundAromatase inhibitor therapy induces bone loss and risk of fracture in postmenopausal breast cancer survivors (PBCS). Targetable patient-level factors to mitigate osteoporosis risk in this population are underreported. Here, we assessed the association between osteoporosis knowledge and beliefs, receipt of bone mineral density, and osteoporosis preventive behaviors among PBCS. MethodsIn this cross-sectional study, early stage PBCS with diabetes mellitus (ages 55-86 years) completed the Facts on Osteoporosis Quiz, Osteoporosis Health Beliefs Scale, and Osteoporosis Preventive Behaviors cross-sectional questionnaires. Multivariate logistic regression assessed factors associated with engagement in strength-training exercise.ResultsMean age was 66.1 years with 20% self-reporting as non-Hispanic White, 40% non-Hispanic Black, 27% Hispanic, and 13% other. Osteoporosis knowledge (10.5±3.4), seriousness (14.9±3.8), and susceptibility (14.0±3.5) mean scores were low. Most (75%) PBCS were adherent to calcium and vitamin D supplements, but only 47% reported engagement in strength-training exercises. Married/partnered, higher osteoporosis knowledge and health motivation scores were associated with exercise. After adjustment of marital status and osteoporosis knowledge, only health motivation was associated with exercise (OR 5.56, 95% CI 1.35-22.93). ConclusionsPBCS are motivated to keep a healthy lifestyle despite limited osteoporosis knowledge, perceived risk, and susceptibility. However, <50% participated in strength-training exercise. Oncologic care should include osteoporosis and fracture prevention strategies, directed at encouraging cancer survivors to increase engagement in strength-training exercises and calcium intake.