Knowledge of osteoporosis in a Swedish municipality--a prospective study

Osteoporosis: a problem still faulty addressed by the Romanian healthcare system. Results of a questionnaire survey of people aged 40 years and over

Purpose

We aimed to investigate the knowledge and awareness level of osteoporosis, its risk factors, the possible causes of underdiagnosis, as well as the preventive measures and lifestyle behavior of the Romanian population.

Patients and methods

A non-interventional, cross-sectional study was performed, consisting of an in-person survey, in 10 pharmacies located in both urban and rural settings in Romania. The survey was distributed to patients ≥40 years old.

Results

Of 189 respondents, 78.8% were women, the majority age group being 60-69 (31.7%) and 50-59 (30.7%) years old and coming from urban areas (69.3%). Although 75.1% of participants declared knowing about osteoporosis, having a moderate level of knowledge, and women being more aware of the pathology, 77.3% have never performed a DXA test. Moreover, participants already diagnosed with osteoporosis did not show a better disease knowledge than those without a diagnosis. Nearly half of the respondents did not know that a family history of the disease increases the risk of developing it and 60% of them thought that symptoms may develop before a fracture occurs. The preventive strategies tend to be disregarded and thus, underused. Moreover, 42.9% of participants reported being diagnosed with osteoporosis, do not undergo treatment, although they are aware of the existence of effective strategies. The dataset was used to build a participant compatibility network. The network's clustering revealed six relevant communities, which are not correlated with questionnaire results but reflect the patterns of feature associations.

Conclusion

Preventive and therapeutic osteoporosis education programs are urgently needed in the Romanian population to decrease disability and high mortality risks and thus, to improve the quality of life.

Awareness About Osteoporosis Among the General Population Based on the Osteoporosis Knowledge Assessment Tool (OKAT): A Cross-Sectional Study in the Northern Border Region of Saudi Arabia

OBJECTIVE

Osteoporosis is a progressive systemic skeletal disease characterized by increasing susceptibility to fractures. The current study was conducted to assess the awareness about osteoporosis among the general population in the Northern Border region of Saudi Arabia to improve awareness and proper planning for public awareness about osteoporosis.

METHODS

The study was conducted as a cross-sectional survey study, based on the online distribution of the Arabic-translated Osteoporosis Knowledge Assessment Tool (OKAT). The questionnaire questions cover the demographic characteristics of the participants, as well as symptoms, risk factors, prevention, and knowledge of treatment centers for osteoporosis in Saudi Arabia.

RESULTS

395 participants were enrolled in the study after their informed consenting. After scoring all correct answers for each participant, the mean score of all participants' answers was 12.5±3.4 (range 0-19). Participants with poor knowledge (0-7 scores), moderate knowledge (8-13 scores), and good knowledge (13-20 scores) represent 61 (15.4%), 213 (53.9%), and 121 (30.6%), respectively. The mean percentage of right answers to all the questions is 44.1%. The highest awareness level was shown in the area of osteoporosis symptoms and risk of fractures, while the lowest was recorded in the questions covering the risk factors. Ages, genders, jobs, and levels of education significantly affected the participants' levels of awareness.

CONCLUSION

The public awareness among the population in the Northern Border region about osteoporosis is less than satisfactory. More awareness activities targeting the risky groups should be planned especially in the area of risk factors and preventive measures for osteoporosis.

Assessment of osteoporosis knowledge among adult Saudi females attending the family medicine department at Security Forces Hospital, Riyadh, Saudi Arabia

Background

Osteoporosis is a skeletal disorder characterized by loss of bone mineral density, deterioration of bone structure, bone fragility, and it is associated with high risk of fractures. The prevalence of osteoporosis among Saudis is estimated to be 34% in females and 30.7% in males. The aim of this study was to know the level of knowledge about osteoporosis among Saudi females at Security Forces Hospital, Riyadh, Saudi Arabia.

Materials and Methods

This was a descriptive and analytical cross-sectional study conducted between January 2019 and January 2020. We used the osteoporosis knowledge assessment tool (OKAT) for data collection. The survey assessed the understanding of symptoms and fracture risk, risk factors, treatment availability and preventive factors for osteoporosis.

Results

The overall knowledge of our 376 participants was good with a mean score of (66%). Participants had more knowledge about the symptoms and fracture risk and the preventive factors such as physical activity and diet compared to the other subscales of the OKAT. There was a significant difference between the knowledge of younger and older females (>40 yrs.), where younger females had lower scores on the OKAT.

Conclusion

This study showed that knowledge about osteoporosis was good among females attending the family medicine clinics in Riyadh, Saudi Arabia. However, younger females were less knowledgeable, which means that more effort should be made to increase the awareness about osteoporosis especially among the younger females.

Application and Effect of Mobiletype-Bone Health Intervention in Korean Young Adult Women with Low Bone Mass: A Randomized Control Trial

PURPOSE

This randomized control trial was designed to examine the effect on the self-managing ability for promoting bone health of mobile type-bone health intervention (mobile type-BHI).

METHODS

The mobile type-BHI consisted of a mobile application called "Strong bone, Fit body" (SbFb) and group education. A total of 82 college women with low bone mass (Z score < -1) participated. They were assigned randomly to three groups, experimental group I, (n = 28), experimental group II (n = 32), and control group (n = 22). This study ran from June 2014 to January 2015. The outcome variables were bone mineral density, minerals related to bone metabolism (calcium, phosphorus, vitamin D), biochemical markers related to bone remodeling (osteocalcin, C-terminal telopeptide, sclerostin), food intake diary by 24 hours recall, and psychosocial variables related to bone health (knowledge, health belief and self-efficacy). Data were analyzed using SAS program and a computer aided nutritional analysis program.

RESULTS

Both the experimental group I, who used mobile type-BHI, and experimental group II, who only received group education, showed outcomes regarding knowledge of the benefits of exercise and calcium as compared with the control group. The two experimental groups also demonstrated results in the serum levels of calcium, vitamin D, and sclerostin compared to those of the control group.

CONCLUSION

Although both experimental groups exhibited positive outcomes in regards to the promotion of bone health, this study did not show an additional effect of the mobile application on self-management ability for the promotion of bone health. Nonetheless, the SbFb application is very meaningful as it is the first application developed with the aim of improving women's bone health.

Long-term effects of a ten-year osteoporosis intervention program in a Swedish population—A cross-sectional study

The aim of the study was to explore long-term effects seven years after the completion of a ten-year community-based osteoporosis intervention program in Vadstena, Sweden. The association between calcaneal bone mineral density and several life style factors, and the impact of risk factors for sustaining a fracture after the age of 50 were also studied. Previous participants in the intervention group, and matched subjects were invited to calcaneal bone mass measurement by a portable device including the dual X-ray and laser (DXL) technology by Calscan, and to complete a questionnaire in 2006. A total of 417 persons (63% of those invited) in the intervention (I) group, and 120 persons (47% of those invited) in the control (C) group participated. Mean age was 63 years (37–94 years). There was somewhat more knowledge of osteoporosis in the I-group (M = 18) than in the C-group (M = 17) (p < 0.05), and more use of shoe/cane spikes in elderly women in the I-group (67%) than in the C-group (40.5%). The fully adjusted model of logistic regression showed that participants with an osteoporotic DXL T-score (≤− 2.5) had a 3-fold increased risk (95%CI 1.48–6.89) of having a history of a self-reported fracture after the age of fifty compared to women with a calcaneal T-score >− 2.5. The long-term effects of a ten-year, community-based, osteoporosis intervention program on knowledge and behavior were modest seven years after its completion.

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The effect of community-based osteoporosis intervention seems modest in the long run.

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Elderly women were compliant with fall prevention advice using spikes in winter.

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An osteoporotic calcaneal T-score may imply increased risk for fracture.

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Moderate/high physical activity was positively associated with calcaneal BMD in men.

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Brisk walks in the summer were positively associated with calcaneal BMD in women.

[Bone mineral density, biochemical bone turnover markers and factors associated with bone health in young Korean women]

PURPOSE

This study was done to assess the bone mineral density (BMD), biochemical bone turnover markers (BTMs), and factors associated with bone health in young Korean women.

METHODS

Participants were 1,298 women, ages 18-29, recruited in Korea. Measurements were BMD by calcaneus quantitative ultrasound, BTMs for Calcium, Phosphorus, Osteocalcin, and C-telopeptide cross-links (CTX), body composition by physical measurements, nutrients by food frequency questionnaire and psychosocial factors associated with bone health by self-report.

RESULTS

The mean BMD (Z-score) was -0.94. 8.7% women had lower BMD (Z-score≤-2) and 14.3% women had higher BMD (Z-score≥0) than women of same age. BTMs were not significantly different between high-BMD (Z-score≥0) and low-BMD (Z-score<0) women. However, Osteocalcin and CTX were higher in women preferring caffeine intake, sedentary lifestyle and alcoholic drinks. Body composition and Calcium intake were significantly higher in high-BMD. Low-BMD women reported significantly higher susceptibility and barriers to exercise in health beliefs, lower bone health self-efficacy and promoting behaviors.

CONCLUSION

Results of this study indicate that bone health of young Korean women is not good. Development of diverse strategies to intervene in factors such as exercise, nutrients, self-efficacy, health beliefs and behaviors, shown to be important, are needed to improve bone health.

Effects of a three-month therapeutic lifestyle modification program to improve bone health in postmenopausal Korean women in a rural community: a randomized controlled trial

In this randomized controlled trial, we examined the effects of a 3-month therapeutic lifestyle modification (TLM) intervention on knowledge, self-efficacy, and health behaviors related to bone health in postmenopausal women in rural Korea. Forty-one women ages 45 or older were randomly assigned to either the intervention (n = 21) or control (n = 20) group. The intervention group completed a 12-week, 24-session TLM program of individualized health monitoring, group health education, exercise, and calcium-vitamin D supplementation. Compared with the control group, the intervention group showed significant increases in knowledge and self-efficacy and improvement in diet and exercise after 12 weeks, providing evidence that a comprehensive TLM program can be effective in improving health behaviors to maintain bone health in women at high risk of osteoporosis.

Relationship of knowledge about osteoporosis with education level and life habits

AIM: To assess possible relationships of knowledge and related factors with educational level and osteoporosis-related life habits.

METHODS: This was a cross sectional study conducted on 268 women (≥ 35 years old) from June 2011 to August 2011. The sample collection was done in outpatient clinics in three university hospitals in Isfahan, Iran. We used a demographic questionnaire containing questions that evaluated osteoporosis-related life habits, including exercise, smoking, intake of calcium and vitamin D supplements and so on. We also used the Osteoporosis Knowledge Assessment Tool to measure osteoporosis knowledge of women.

RESULTS: The mean level of knowledge about awareness of osteoporosis, its risk factors and preventive factors were 56, 55 and 22, respectively. The relationship of education level and awareness of osteoporosis, its risk factors and preventive factors was significant, with R = 0.76, R = 0.73 and R = 0.83, respectively (P < 0.001). The relationship of education level and osteoporosis-related life habits was not significant (R = 0.03 and P = 0.56). The relationship of osteoporosis-related life habits and awareness of osteoporosis and its risk factors was significant, with R = 16%, P = 0.006 and R = 16%, P = 0.008, respectively, but the relationship of osteoporosis-related life habits and preventive factors was not significant (R = 0, P = 0.99).

CONCLUSION: Iranian women with a higher education level have significantly better knowledge about osteoporosis than women with a lower educational level but they do not use this knowledge in their life.

A Comparison of Cognitive and Everyday Functional Performance among Older Adults With and Without Hypertension

Secondary data analyses examined the differences in cognitive and instrumental activities of daily living (IADL) performance among hypertensive individuals taking one of four classes of antihypertensive medications, hypertensive individuals not taking any antihypertensive medications, and normotensive individuals (N=770). After adjusting for covariates, significant group differences were evident on all measures (speed of processing, motor speed, reaction time, ps < .05) except memory and Timed IADL (ps > .05). Follow-up a priori planned comparisons compared hypertensive individuals not on medications to each of the four antihypertensive medication groups. Results indicated that only those on beta blockers (BB) were significantly slower in speed of processing (ps < .05). A priori planned comparisons also revealed that normotensive individuals had better cognitive performance on measures of processing speed, motor speed, and reaction time than hypertensive individuals regardless of antihypertensive medication use. Additionally, normotensive individuals performed significantly better on memory (Digit and Spatial Span) than individuals with hypertension on medications. No differences were found between groups on memory (Hopkins Verbal Learning Test) or Timed IADL performance. With regard to antihypertensive medications, the use of BBs was associated with slowed processing speed. These analyses provide empirical evidence that hypertension primarily impacts speed of processing, but not severe enough to affect IADL performance. Given the contribution of processing speed to memory and executive function performance, this is an important finding. Clinicians need to take into consideration the potential negative impact that BBs may have on cognition when determining the best treatment of hypertension among older adult patients.

Female College Students' Knowledge, Self-efficacy and Health Behaviors related to Bone Health

PURPOSE

This study described female college students' knowledge, self-efficacy and health behaviors related to bone health.

METHODS

A descriptive cross-sectional survey design was used. A total of 214 students were conveniently recruited from a school of nursing in Korea. Participants (mean age=21.2, SD=1.9 years) bone mineral density (BMD) was measured using dual energy x-ray absorptionmetry. Participants also completed a questionnaire consisting of knowledge test, self-efficacy scale and health behaviors related to bone health. Data were analyzed using SPSS/WIN 17.0 program.

RESULTS

The mean BMD at left femoral neck site was 0.86 g/cm2 and 6.1~12.6%. Results showed that participants were below the expected range of BMD. Level of knowledge (correct rate=54%) and self-efficacy were moderate (mean 54.8 out of 84). More than 84% of subjects drank alcohol more than once a month and 58.4% did participate in regular exercise. Only 7.9% participants took calcium and vitamin-D rich foods every day. There were significant positive correlations between knowledge and self-efficacy (r=.17), health behaviors (r=.14) and self-efficacy and health behaviors (r=.28, all p<.05).

CONCLUSION

These results suggest that health care professionals need to provide effective interventions for young women in order to enhance knowledge, self-efficacy and health behaviors related to bone health.

Gender differences in osteoporosis health beliefs and knowledge and their relation to vigorous physical activity in university students

OBJECTIVE

The purpose of this cross-sectional investigation was to examine (1) gender differences in osteoporosis-related knowledge and beliefs and (2) if these beliefs could predict vigorous physical activity behavior in university students.

PARTICIPANTS

Male (n = 176) and female (n = 351) university students participated in the study.

METHODS

Participants completed self-report measures of osteoporosis knowledge and health beliefs and vigorous physical activity.

RESULTS

Regardless of gender, osteoporosis knowledge was relatively poor. Women reported higher knowledge, perceived susceptibility, perceived severity, and calcium barriers, and lower exercise self-efficacy than men. Regression analyses showed that for women, perceived susceptibility, health motivation, and exercise self-efficacy predicted vigorous physical activity, whereas for men, exercise barriers was the only predictor.

CONCLUSIONS

Gender differences in osteoporosis health beliefs appear to be greater in older adults than college-aged students. Interventions designed to increase vigorous physical activity may want to target different beliefs for men and women.

Male and non-English-speaking patients with fracture have poorer knowledge of osteoporosis

BACKGROUND

Prior fracture is a strong independent risk factor for subsequent fracture. To date, few studies have examined the level of osteoporosis knowledge specifically in the population of patients who have sustained a fracture. This study was designed to assess the knowledge of osteoporosis among patients who sustained a fracture and who were forty years of age or older, as well as to identify what social factors and health and fracture characteristics determine the level of osteoporosis knowledge in this population.

METHODS

Patients who had sustained a fracture and were attending fracture clinics at two Toronto hospitals were identified and invited to fill out a questionnaire during their visit. This questionnaire included questions that could be answered by checking "true," "false," or "don't know" and that were designed to assess the patient's knowledge of osteoporosis. The questionnaire also included questions about the respondent's background.

RESULTS

Of 259 patients identified as eligible for the study, 204 (78.8%) agreed to participate. The mean number of correct responses was 16.5 (55%) out of thirty responses. Variables significantly associated with greater numbers of correct responses were female sex, English as a first language, being currently employed, exercising regularly, and having received information from a health-care provider or from a newspaper or magazine.

CONCLUSIONS

The level of osteoporosis knowledge was fairly low among the surveyed patients, indicating that more education is needed. This study also highlighted certain characteristics (i.e., male sex, English as a second language, being unemployed, and not exercising) that are associated with a lower level of knowledge. Our results can help target certain groups for osteoporosis educational initiatives, especially ethnic groups whose first language is not English, so as to appropriately reduce the risk of future fractures in this high-risk population.

The Relationship between Knowledge, Health Beliefs, and Prevention Behaviors of Osteoporotic Fracture in Patients receiving Osteoporosis Treatment

PURPOSE

This study was to examine the relationship of knowledge, health beliefs, and prevention behaviors of osteoporotic fracture in outpatients with osteoporosis.

METHODS

The subjects were 120 outpatients receiving osteoporosis treatment on K hospital in G city from Dec. 2007 to Feb. 2008. Questionnaires were collected and analyzed using the SPSS/WIN 12.0 program for descriptive statistics, and t-test, ANOVA, and Pearson correlation coefficient.

RESULTS

Subjects were treated for fracture about 28 months. The mean score of knowledge, health belief and prevention behaviors in subjects were 17.5 +/- 3.22, 2.8 +/- 0.23 and 2.8 +/- 0.38 respectively. The score of health belief recorded the lowest point. However, the score of knowledge varied with general and disease-related characteristics of subjects. In contrast, the score of prevention behaviors did not showed any significant differences. Fracture prevention behavior in subjects showed rather higher relationship with the health belief system than the knowledge of fracture prevention.

CONCLUSION

The present work suggested that education program for prevention behaviors of fracture should be developed to focus on altering the health belief system rather than the knowledge of osteoporotic fracture prevention. Furthermore, individual education program based on living circumstances and daily life habits should be also developed.

Effects of an osteoporosis educational programme for men

AIM

This paper reports an evaluation of the effects on knowledge, health beliefs and preventive behaviours of an osteoporosis educational programme for men.

BACKGROUND

Osteoporosis is an increasing global health concern, and educational programmes have been identified as a crucial strategy in its prevention. However, the effectiveness of osteoporosis educational programmes has mainly been evaluated in women.

METHODS

A randomized controlled trial was carried out to identify the effects of an osteoporosis educational programme for men. The study was conducted between September 2004 to February 2005, and 128 Hong Kong Chinese men were randomly assigned to an intervention or control group, with 64 in each group. The intervention group attended an osteoporosis educational programme. All participants completed pre- and post-test self-administered questionnaires: Osteoporosis Knowledge Test, Osteoporosis Health Belief Scale and Osteoporosis Self-Efficacy Scale.

RESULTS

The intervention group showed a statistically significant increase in both knowledge (P < 0.0005) and health beliefs (P = 0.007) about osteoporosis and preventive behaviours in comparison with the control group. However, the difference in self-efficacy between the two groups was not statistically significant (P = 0.154).

CONCLUSIONS

An osteoporosis educational programme can increase men's knowledge levels and change their health beliefs about osteoporosis and preventive behaviours. This approach should be more widely used in nursing practice to promoting the adoption of osteoporosis prevention behaviours in men.

Perceived risk of osteoporosis: restricted physical activities? Qualitative interview study with women in their sixties

OBJECTIVE

To explore elderly women's physical activity in relation to their perception of the risk of osteoporosis.

DESIGN

Qualitative study using in-depth interviews.

SETTING

Informants were purposely selected from a Danish population-based, age-specific cohort study conducted in the county of Copenhagen with people born in 1936.

SUBJECTS

Women in their sixties.

RESULTS

Women who perceived a current risk of osteoporosis tended to reduce their physical activity in an attempt to reduce the risk of bone damage. This behaviour was related to the imagined fragility of the bones (the risk inside the body), and the actual situations (the risk outside the body), including places and activities. Knowledge of a reduced bone mass reinforced the women's uncertainty about what their bones could endure. Experiences managing physical activity without injury resulted in reinterpretations of their risk of bone fractures and increased physical activity.

CONCLUSIONS

Perceived risk of osteoporosis may lead to decreased physical activity and hence actually increase the risk. When informing individuals about health risk people's images and imaginations of the actual risk have to be acknowledged. When a bone scan is being considered, explicit advice encouraging physical activity - especially the weight-bearing kind - should be stressed.

Impact of a community-based osteoporosis and fall prevention program on fracture incidence

Associations between a 10-year community-based osteoporosis and fall prevention program and fracture incidence amongst middle-aged and elderly residents in an intervention community are studied, and comparisons are made with a control community. A health-education program was provided to all residents in the intervention community, which addressed dietary intake, physical activity, smoking habits and environmental risk factors for osteoporosis and falls. Both communities are small, semi-rural and situated in Ostergotland County in southern Sweden. The analysis is based on incidences of forearm fractures in the population 40 years of age or older, and hip fractures in the population 50 years of age or older. Data for three 5-year periods (pre-, early and late intervention) are accumulated and compared. In the intervention community, forearm fracture incidence decreased in women. There are also tendencies towards decreasing forearm fracture incidence in men, and towards decreasing trochanteric hip fracture incidences in women and in men in the late intervention period. No such changes in fracture incidences are found in the control community. Cervical hip fracture incidence did not change in the intervention and the control communities. Although the reported numbers of fractures are small (a total of 451 forearm and 357 hip fractures), the numbers are based on total community populations and thus represent a true difference. The decrease in forearm fracture incidence among women, and the tendency towards decreasing trochanteric hip fractures, in contrast to the absence of change in cervical hip fractures, might be mainly due to a more rapid effect of fall preventive measures than an increase in bone strength in the population. For the younger age groups an expected time lag between intervention and effect might invalidate the short follow-up period for outcome measurements. Thus, the effect of the 10-year intervention program on fracture incidence should be followed during an extended post-intervention period.

Knowledge about osteoporosis: assessment, correlates and outcomes

During the last 10 years, we have witnessed an impressive increase in the number of studies examining knowledge about osteoporosis. The aim of the present paper is to examine the status of research on knowledge about osteoporosis by reviewing and analyzing the current literature as it pertains to assessment of knowledge about osteoporosis, factors associated with knowledge, and relationship between knowledge about osteoporosis and participation in health-related behaviors. Finally, future directions in the field are discussed. Many of the studies are still characterized by the lack of a theoretical framework, as well as by various methodological flaws. Serious deficits in knowledge are reported among healthy and diagnosed women and men, as well as among health professionals. Educational interventions are accompanied by an increase in knowledge, but no change in behavior. There is need to expand the research on knowledge about osteoporosis, especially in an effort to increase its impact on the prevention and early diagnosis of the disease. The deficits found in the knowledge of both the general population and among health care professionals, should be addressed by providing updated and reliable information through appropriate health promotion and professional venues.

Effects of bone density feedback and group education on osteoporosis knowledge and osteoporosis self-efficacy in premenopausal women: a randomized controlled trial

In this 2-yr randomized controlled trial, we examined the effect of bone mineral density feedback and two different educational interventions (an osteoporosis information leaflet and group-based behavioral education [OPSMC]) on osteoporosis knowledge and self-efficacy in 470 women aged 25-44 yr. Osteoporosis knowledge increased across all intervention groups. Women receiving the OPSMC had a greater increase in both short (beta = +1.33, 95% confidence interval [CI] = 0.72-1.94) and long-term (beta = +0.64, 95% CI = 0.0034-1.25) osteoporosis knowledge, compared to those receiving the leaflet. In contrast, a low T-score was associated with a significant increase in long-term (beta = +0.66, 95% CI = 0.0034-1.25) but not short-term (beta = +0.57, 95% CI = -0.036 to 1.17) osteoporosis knowledge, compared to a normal T-score. Changes in osteoporosis self-efficacy were not associated with either low bone mineral density or receiving the OPSMC but were negatively associated with number of children (beta = -0.9, 95% CI = - 1.4 to -0.3) and working more than 20 h per week (beta = -2.7, 95% CI = -4.6 to -0.8). In conclusion, both the OPSMC and bone density feedback increased osteoporosis knowledge but not self-efficacy over 2 yr. Women with children or who worked full time have decreased osteoporosis self-efficacy, suggesting that this group should be a specific target for future interventional strategies.

The design of a valid and reliable questionnaire to measure osteoporosis knowledge in women: the Osteoporosis Knowledge Assessment Tool (OKAT)

BACKGROUND

Osteoporosis knowledge is an important contributor to improving exercise and calcium intake behaviour. However, there are few validated instruments for measuring osteoporosis knowledge levels. The aim of this study was to design a valid and reliable instrument to measure osteoporosis knowledge in Australian women.

METHODS

A 20 item instrument with true, false and don't know responses was drafted, based on the Osteoporosis Australia Osteoporosis Prevention and Self-management course and the information leaflet "Understanding Osteoporosis". The scoring range was 1 to 20. This was administered to a 467 randomly-selected, healthy women aged 25-44 years. Questionnaire performance was assessed by Flesch reading ease, index of difficulty, Ferguson's sigma, inter-item and item-total correlations, Cronbach's alpha and principal component factor analysis.

RESULTS

Flesch reading ease was higher than desirable at 45, but this was due to the use of the word osteoporosis in many items. Of the individual items 17 had an index of difficulty less than 0.75. The questionnaire had a Ferguson's sigma of 0.96, a Cronbach's alpha of 0.70 and factor analysis consistent with only one factor (osteoporosis knowledge) being measured. Levels of osteoporosis knowledge were low with a mean score of 8.8 out of 20 which suggests the OKAT may be sensitive to change.

CONCLUSIONS

The OKAT for measuring osteoporosis knowledge has good psychometric properties in Australian 25-44 year old females. While it should be applicable to other Caucasian populations, this will require confirmation by further research.