Bone density, health beliefs, and osteoporosis preventing behaviors in men.

PURPOSE: To examine the effect of bone mineral density (BMD) screening via dual-energy x-ray absorptiometry (DXA) results on osteoporosis preventing behaviors (OPB), knowledge of osteoporosis, and health beliefs of men aged 50 years or older (N = 196) was evaluated. DESIGN: An experimental, 2-group longitudinal design was used. The independent variable was DXA, dependent variables were osteoporosis preventing behaviors, and mediating variables were general knowledge of osteoporosis and Health Belief variables. Half of the men had low bone density. Men diagnosed to be osteoporotic increased their calcium intake. FINDINGS: Health belief variables predicted calcium intake and/or exercise. In addition, 9 men in the experimental group were taking medications to prevent/restore bone loss at Time 3. Healthcare providers play a significant role in assessing bone loss and preventing and treating osteoporosis in men. IMPLICATIONS: The cost of a DXA screen is far less than financial and social costs due to osteoporotic fractures.

Structural model for osteoporosis preventing behavior in men.

This longitudinal study evaluates the effect of bone mineral density screening on calcium intake and daily exercise of 196 healthy men older than 50 years over a period of 1 year. In this randomized clinical trial, the experimental group received personal bone density information via dual-energy X-ray absorptiometry (DXA). The men completed measures addressing knowledge, health beliefs, calcium intake, and exercise behaviors. Outcome measures were collected by a questionnaire at three time points: initial (Time 1 [T1]; pre-DXA), 6 months (Time 2 [T2]), and 12 months (Time 3 [T3]). Using structural equation modeling for data analysis, results indicated that men in the experimental group had a significantly higher T2 calcium intake than the control group, with no additional direct effect at T3. T1 daily calcium intake was significantly predicted by T1 health beliefs. Men with higher levels of health motivation tended to have higher initial levels of daily calcium intake. Personal knowledge of DXA results relate significantly to increased calcium intake.

Validation of the Osteoporosis Smoking Health Belief instrument.

Smoking has a deleterious effect on bone mineral density. Psychometric properties were conducted for 3 smoking cessation subscales of the Osteoporosis Smoking Health Belief (OSHB) instrument: barriers, benefits, and self-efficacy. The instrument was evaluated by 6 nurse researchers, administered to a pilot sample of 23 adult smokers aged 19-39, and to a convenience sample of 59 adult smokers aged 19-84 years attending bingo at churches and community centers. Principal components factor analyses were conducted on the 18 items at both time points and accounted for 65.05% of the variances in the matrix at Time 1 and 71.19% at Time 2. The 3 statistical factors corresponded to the theoretically derived concepts. Cronbach's alphas for benefits of not smoking were .86 at Time 1 and .88 at Time 2; for barriers, .78 at Time 1 and .89 at Time 2; and for self-efficacy, .94 at Time 1 and .96 at Time 2. The test-retest correlations were .68 for benefits, .74 for barriers, and .79 for self-efficacy. Paired t tests showed no significant change over time. The OSHB meets relevant measurement criteria.

Osteoporosis knowledge, health beliefs, and DXA T-scores in men and women 50 years of age and older.

PURPOSE: To compare the knowledge of osteoporosis, revised health belief model variables (RHBM), and DXA (dual energy x-ray absorptiometry) T-scores among men and women 50 years of age and older. DESIGN: This was a secondary analysis that used 218 healthy community-based women 50 to 65 years of age and 226 healthy community-based men >or=50 years of age. Data for women were collected for 18 months during 2001-2003, and data for men were collected for 18 months during 2004-2006. The variables were knowledge of osteoporosis, RHBM variables (susceptibility, seriousness, benefits and barriers of calcium intake and of exercise, health motivation, self-efficacy of calcium intake and exercise), and DXA T-scores. METHOD: The women and men completed an osteoporosis questionnaire prior to having a DXA screening test. A total of 190 women and 187 men had DXA scans. FINDINGS: More than half of the sample had abnormal bone density scans. Knowledge of osteoporosis was low for women and even lower for men. Seven of the nine health belief variables were associated with gender. Women perceived osteoporosis to be serious and that they were susceptible. Men did not perceive osteoporosis to be serious or that they were susceptible. Men were more health motivated and more confident of their ability to engage in exercise.

DXA, health beliefs, and osteoporosis prevention behaviors.

OBJECTIVE: This experimental longitudinal study was designed to examine the relationship between having a bone density through dual energy X ray absorptiometry (DXA) and osteoporosis preventing behaviors (OPB) among healthy postmenopausal women. METHODS: Subjects were 203 healthy community-based women 50-65 years of age. Mediating variables were general knowledge of osteoporosis and revised health belief model variables. Treatment group women (n = 101) had a DXA screen and control group women (n = 102) did not. Study questionnaires were completed at three time points; initially and at 6 months and 12 months. RESULTS: Repeated measures ANOVA revealed treatment group women scored significantly higher on perceived susceptibility and calcium intake. Wilks's Lambda F revealed a significant difference in use of osteoporosis preventing medications. DISCUSSION: Personal knowledge gained from DXAs increased perceived susceptibility to osteoporosis, calcium intake, and use of osteoporosis preventing medications and appears to be an effective intervention in promoting OPB in younger postmenopausal women.

Structural model for osteoporosis preventing behavior in postmenopausal women.

BACKGROUND: Osteoporosis prevention behaviors (OPBs) can prevent and delay bone deterioration; dual-energy X-ray absorptiometry (DXA) scan can identify osteoporosis and provide personal osteoporosis risk information that may promote prevention behaviors. OBJECTIVES: This study was designed to estimate relationships between receiving personal knowledge of bone mineral density (gained through DXA scan), general knowledge of osteoporosis, health beliefs, and the two OPBs of calcium intake and weight-bearing exercise in healthy postmenopausal women 50 to 65 years. METHODS: In this longitudinal, randomized clinical trial (including covariates), receipt of personal DXA information was manipulated by random assignment to the experimental or control group. The remaining antecedent and outcome variable measures were collected by questionnaire at three time points (initial [T1; pre-DXA], 6 months [T2], 12 months [T3]) and by bone density assessment from 203 women over an 18-month period in 2001-2003. RESULTS: The experimental manipulation (DXA results) had a direct positive effect (beta = .23, p < .05) on calcium intake at T2, and indirectly at T3 through T2. Women in the experimental group who were informed they had osteopenia or osteoporosis had a greater T1-T2 change in daily calcium intake than those with normal bone density (beta = .23, p < .05). However, providing DXA results did not relate to change in exercise. Health beliefs and general osteoporosis knowledge predicted initial calcium and exercise levels; there was tentative evidence that susceptibility beliefs partially mediate between DXA results and change in calcium intake. DISCUSSION: Personal knowledge of DXA results was related significantly to increases in calcium intake in postmenopausal women, but not to exercise. Directions for further study are discussed.

Tailored interventions to enhance osteoporosis prevention in women.

PURPOSE: The purpose of this pilot study was to determine if tailored nursing interventions based on personal knowledge of bone mineral density from a dual-energy x-ray absorptiometry cause increases in knowledge of osteoporosis, health beliefs, or osteoporosis-prevention behaviors in postmenopausal women 50-65 years of age, 6 months after the intervention. METHOD: The design for this pilot study was a two group quasi-experimental design. The treatment group received a tailored intervention; the control group did not. Outcome data were gathered at 6 months after dual-energy x-ray absorptiometry. The tailored intervention was designed and given to each woman via telephone using her dual-energy x-ray absorptiometry results and osteoporosis questionnaire data that addressed her knowledge of osteoporosis and osteoporosis-prevention behaviors of calcium intake, exercise, smoking, and alcohol use. A written mailed copy of the intervention followed the telephone interview. Six months after the intervention, the women were mailed another osteoporosis questionnaire to determine if the tailored intervention made a difference in the outcome variables. SAMPLE: A total 124 women between the ages of 50 and 65 (101 control, 23 treatment) comprised the sample. RESULTS: There was no difference in knowledge between groups. On the average, there were significantly more perceived barriers to calcium in the tailored group (mean = 13.48) than in the nontailored group (mean = 11.55) (t = 2.147; df = 122; p = .034). There were significantly more perceived barriers to exercise in the tailored group (mean = 14.39) than in the nontailored group (mean = 12.21) (t = .144; df = 122; p = .034). Daily calcium intake increased in both the tailored and the nontailored groups. The tailored intervention increased women's daily calcium intake from 614.28 to 1039.10 mg (t = -2.896; df = 22; p = .008). The nontailored group daily calcium intake increased from 587.91 to 916.30 mg (t = -3.541; df = 100; p = .001); there was no significant difference between the groups. Weight-bearing exercise behaviors decreased from 96.04 minutes to 59.2 minutes in the tailored group but increased slightly in the nontailored group from 81.47 to 87.26 minutes of exercise. CONCLUSION: Tailored interventions increased women's perceived barriers to calcium and exercise. Both groups increased calcium intake. The mixed findings of increased perception of barriers to calcium and exercise and decreased exercise behaviors indicate the need for further study. This important intervention has implications for orthopaedic nurses and healthcare professionals involved in health promotion and prevention of osteoporosis.