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

Health Belief Scale for Urinary Incontinence and Kegel Exercise: A Reliability and Validity Study

PURPOSE

The aim of this study was to develop an instrument based on the Health Belief Model that measures urinary incontinence awareness and beliefs regarding pelvic floor muscle (Kegel) exercises.

DESIGN

Evaluation of validity and reliability of the novel instrument and analysis of sociodemographic variables based on responses to this 49-item scale.

SUBJECTS AND SETTING

The sample used to validate the instrument (n = 527) was drawn from patients cared for at the gynecology and obstetrics and urology polyclinic at Ondokuz Mayıs University Hospital. A majority of participants were female (n = 431, 81.8%) and their average age was 33.8 years (SD 12.3). The university is located in Samsun, a city located in northern Turkey. Data were collected between October 2019 and December 2020.

METHODS

The Health Belief Scale for Urinary Incontinence and Kegel Exercise's validity was analyzed using a content validity index approach with 8 experts. Psychometric measurements were obtained using exploratory factor analysis and Cronbach's α reliability analysis. Exploratory factor analysis incorporated principal component analysis and varimax rotation. t Tests and 1-way analysis of variance were used to compare subdimensions of the Health Belief Scale for Urinary Incontinence and Kegel Exercise with some variables (sex, education status, marital status, make Kegel exercises regularly, etc).

RESULTS

Results supported a scale having 49 items and 6 subscales per factor analysis explaining 59.8% of total variance. With exploratory factor analysis, the Kaiser-Meyer-Olkin coefficient was 0.899 and Barlett test result was χ² = 18389.424 (P = .001). Cronbach's α coefficients for the scale varied between 0.79 and 0.94. Factor loadings per underlying dimensions ranged from 0.42 to 0.84.

CONCLUSION

The Health Belief Scale for Urinary Incontinence and Kegel Exercise is a valid and reliable instrument.

Gender Disparities in Osteoporosis Knowledge, Health Beliefs and Preventive Behaviors in Najran City, Saudi Arabia

Osteoporosis is a chronic bone disease affecting both men and women, but it is more prevalent in women. Promoting a healthy lifestyle among adults, particularly women, is crucial in preventing and reducing the osteoporosis impact. This study aimed to compare the osteoporosis knowledge, health beliefs and preventive behaviors among adult male and female in Najran city Saudi Arabia. This cross-sectional study was performed on 516 males and 581 females in Najran City, Saudi Arabia, from January to April 2023. The data collection instrument is a self-reported online questionnaire consisting of basic data, the Osteoporosis Preventive Behavior (OPB) scale, the osteoporosis knowledge assessment tool, and the osteoporosis health belief scale. The results revealed that male participants had a higher OPB (26.70) than females (20.32). However, females have a higher knowledge (10.71), perceive themselves as more susceptible to osteoporosis (20.34) and had higher exercise barriers (20.11) compared to males (9.97, 18.79 and 19.20, respectively). Statistically significant correlations (p < 0.001) were observed between OPB, osteoporosis knowledge (r = 0.26), perceived susceptibility (r = 0.33), severity (r = 0.53), exercise (r = 0.54) and calcium (r = 0.33) benefits, exercise (r = 0.40) and calcium (r = 0.81) barriers and health motivation (r = 0.37). The study concluded significant disparities between males and females regarding osteoporosis-related knowledge, preventive behaviors, perceived susceptibility, severity, and exercise perceived barriers. The results suggest gender-based educational interventions to enhance OPB by addressing osteoporosis-related knowledge, perceived susceptibility, seriousness, benefits, and health motivation.

Application of health belief model in the assessment of factors affecting exercise behaviours in preventing osteoporosis

Objectives

Osteoporosis is a skeletal disorder associated with weak and brittle bones, and more susceptible to fracture. Osteo-protective behaviours, such as exercise, may prevent osteoporosis. Therefore, this study aimed to assess the factors influencing the exercise behaviour in Malaysian adults and to assess their health beliefs and self-regulation in preventing osteoporosis.

Methods

A cross-sectional, self-administered questionnaire was conducted throughout Malaysia through a web-based or physical-based survey. The questionnaire consisted of three sections: demographic data, ten questions regarding social and family history related to osteoporosis and 38 questions with seven subdomains (i.e. susceptibility, seriousness, barriers, benefits, health motivation, self-efficacy and self-regulation) which measured the health belief scores and self-regulation using 5-point Likert scale. Descriptive, inferential analysis and linear regression were used to analyse the data.

Key findings

A total of 679 participants completed the questionnaire. The mean health belief score was 63.7%, which was moderate. Most participants (64.4%) perceived low susceptibility to osteoporosis [mean score = 47.0%, standard deviation (SD) = 16.2]. Participants with age 18–27 years (44.8%), single (45.0%) and monthly income &lt;RM 1000 (45.2%), perceived significant lower susceptibility to osteoporosis. Participants’ perception scores were high on the benefits of exercise (75.7%, SD = 16.4), health motivation (74.9%, SD = 17.1) and perceived low barriers to exercise (71.7%, SD = 14.9). Respondents who were at risk of osteoporosis and with family and friends diagnosed with osteoporosis obtained a higher score than those who did not.

Conclusions

The health belief score in the Malaysian population was moderate. However, the majority of participants were unaware of the susceptibility and seriousness of osteoporosis. Efforts need to be taken to break the barriers associated with exercise in preventing osteoporosis.

Associations between cardiometabolic risks and physical activity in early adulthood: a cross-sectional study

OBJECTIVES

Young adults' physical activity (PA) is a foundation of creating future healthy lifestyles. The purpose of this study was to explore differences in PA, sedentary behaviour, walkability and health beliefs among young adults with different levels of cardiometabolic risks and the influence of moderate-to-vigorous PA.

DESIGN

A cross-sectional study was conducted using a structured questionnaire.

PARTICIPANTS

Totally, 1149 valid responses were received for a response rate of 86.32%. According to the self-reported worst health condition, participants were categorised into healthy adults, and adults at levels 1 (overweight), 2 (obese), 3 (hypertensive, hyperlipidaemic, and/or hyperglycaemic), and 4 (with a diagnosis of cardiometabolic diseases) of cardiometabolic risks.

PRIMARY OUTCOME MEASURES

PA, sedentary time, walkability and health beliefs.

RESULTS

Significant differences in PA (F=3.78, p<0.01) and sedentary time (F=2.39, p<0.05) among groups with various cardiometabolic risk levels were found. Healthy adults and adults at level 1 risk had significantly higher PA than adults at risk levels 2 and 3. Young adults at risk level 3 were less likely to participate in moderate-to-vigorous PA than were healthy adults (OR=0.64 (95% CI 0.41 to 0.99), p<0.05). Individuals who perceived that there were more recreational facilities (OR=1.27 (1.05 to 1.53), p<0.05), who had higher benefits of exercise (OR=1.73 (1.30 to 2.31), p<0.001), and who had lower barriers to exercise (OR=0.42 (0.32 to 0.55), p<0.001) were more likely to participate in moderate-to-vigorous PA.

CONCLUSIONS

Being aware of body weight changes could be a danger sign of a lack of PA. Developing environmental and psychological strategies to promote engaging in PA is necessary to promote the cardiometabolic health of young adults.

Health Status, Behaviors, and Beliefs of Health Sciences Students and Staff at Kuwait University: Toward Maximizing the Health of Future Health Professionals and Their Patients

Health professionals who engage in healthy lifestyle behaviors are more likely to promote their patients’ health. We evaluated health status, behaviors, and beliefs of students (future health professionals) and staff in four health sciences faculties, Kuwait University. In total, 600 students and 231 staff participated in this descriptive cross-sectional study. Questionnaire surveys were used to evaluate lifestyle-related practices and participants’ beliefs about these practices, in addition to health-related objective measures, e.g., heart rate, blood pressure, and body mass index. Overweight/obesity was prevalent among the participants (staff, 68.7%, students, 48.1%; p < 0.001); 57% of staff had suboptimal resting blood pressures. About half of the participants reported being moderately physically active (staff, 44.8%, students, 52.6%; p < 0.05), and most reported moderate/high stress (staff, 88.8%, students, 90.9%; p > 0.05). Only 25.1% of staff and 27.9% of students reported at least 8 h sleep nightly (p > 0.05). Staff reported healthier dietary practices than students (p-value range < 0.001–0.02). Overall, the participants had sub-optimal health indices. A marked gap existed between participants’ beliefs about healthy lifestyle practices and their actual health status. Healthy lifestyle programs are needed on campus with respect to diet, exercise, and stress management. As emerging health professionals, students in health sciences faculties, Kuwait University, need exposure to a health-promoting environment including healthy staff as role models.

Levels of Knowledge, Beliefs, and Practices Regarding Osteoporosis and the Associations with Bone Mineral Density among Populations More Than 40 Years Old in Malaysia

Osteoporosis is a skeletal disorder commonly found among the elderly, in which the bones become weak, brittle, and more susceptible to fracture. Adequate knowledge and positive attitude towards the disease and osteoprotective activities may prevent osteoporosis, but comprehensive studies to verify this hypothesis are limited in Malaysia. This study aims to bridge the research gap by determining the levels of knowledge, beliefs, and practices regarding osteoporosis and their associations with bone mineral density (BMD) among men and women ≥ 40 years in Klang Valley, Malaysia. In this cross-sectional study, 786 Malaysians (382 men, 404 women) completed a questionnaire on knowledge, beliefs, and osteoprotective practices, and underwent BMD scan using a dual-energy X-ray absorptiometry device. The current study found moderate levels of knowledge and beliefs regarding osteoporosis but poor osteoprotective practices. Osteoporosis knowledge, beliefs, and practices were significantly different based on subjects' demographic characteristics (p < 0.05). Osteoporosis knowledge and beliefs were correlated significantly with osteoprotective practices (p < 0.05). Bone health status of the subjects was associated positively with calcium supplement intake, and negatively with exercise barriers and smoking status of the subjects (p < 0.05). However, no significant correlation was noted between osteoporosis knowledge and bone health (p > 0.05). Conclusively, despite some correlations between individual components, the detachment between bone health knowledge and beliefs, and osteoprotective practices among Malaysians is apparent. Integrating all three components into a comprehensive osteoporosis prevention program is warranted.

Gendered perceptions of osteoporosis: implications for youth prevention programs

The presentation of osteoporosis as a woman's disease in prevention information influences how osteoporosis is perceived and how prevention information is internalized and applied. Using the Health Belief Model as a framework, gendered perceptions of osteoporosis were investigated in Canadian young adults to inform the design of prevention programs. A combination of the Osteoporosis Health Belief Scale (OHBS) and semi-structured interviews were used to explore participants' perceptions of osteoporosis severity, susceptibility, and motivation to engage in prevention activities. Sixty multiethnic men and women aged 17-30 years living in Hamilton, Ontario, Canada participated in the study. While the findings from the OHBS indicated that both genders scored high for self-efficacy, the results from the qualitative interviews showed ambivalent attitudes toward prevention behaviors, indicating a disconnect between quantitative and qualitative findings. Perceptions related to severity and susceptibility revealed that while osteoporosis was generally viewed as a woman's disease, perceived individual risk of disease was a negotiation between larger gender constructs of osteoporosis and a variety of risk factors. This study indicates that osteoporosis prevention programs should consider actively acknowledging gendered and youth-based conceptions of osteoporosis in order to increase prevention behaviors in the whole population to reduce future disease.

A Review of Knowledge, Belief and Practice Regarding Osteoporosis among Adolescents and Young Adults

Osteoporosis is a major public health problem affecting millions of people worldwide. Increasing knowledge, correcting health belief and promoting osteoprotective practices are effective measures for building and maintaining strong bone throughout ones’ life-span. This review aims to summarize the contemporary evidence on the knowledge, beliefs and practice of adolescents and young adults on bone health. We performed literature searches using the PubMed and Scopus databases to identify original studies from 2008 to May 2018 using the search terms “(knowledge OR beliefs OR attitude OR practice OR behaviours OR physical activity OR exercise OR diet OR nutrition) AND (young OR youth OR adolescents OR children OR young adults OR students OR teenager) AND (osteoporosis OR bone health)”. Of the 3206 articles found, 34 met the inclusion criteria. Studies showed that most adolescents and young adults had poor knowledge and expressed disinterest in osteoporosis. They believed that other diseases were more serious than osteoporosis, contributing to low perceived susceptibility and seriousness towards this disease. Popular media emerged as a platform to obtain information regarding osteoporosis. The lack of knowledge and misconceptions about osteoporosis led to poor osteoprotective practices. As a conclusion, the current evidence revealed a lack of awareness about osteoporosis among adolescents and young adults. Educational interventions may be useful to improve the awareness of osteoporosis among this population.

Osteoporosis knowledge and beliefs in diabetic patients: a cross sectional study from Palestine

BACKGROUND

Osteoporosis is a potential metabolic complication of diabetes mellitus (DM). Therefore, patients with DM should have adequate osteoporosis knowledge and beliefs in order to get engaged in osteoporosis preventive behaviors. The objective of this study was to assess osteoporosis knowledge and beliefs among diabetic patients.

METHODS

This was a cross sectional study carried out at Al-Makhfiah governmental primary healthcare unit in Nablus, Palestine from September 2016 to December 2016. The tools used to assess knowledge and beliefs were Osteoporosis Health Belief Scale (OHBS) and the Osteoporosis Knowledge Test (OKT) respectively.

RESULTS

Three hundred diabetic patients were interviewed regarding their knowledge and belief about osteoporosis. The study sample included 192 (64.0%) females. Mean ± standard deviation (SD) of the participants was 58.5 ± 9.3 years. Regarding co-morbidities, 229 (76.3%) had at least one co-morbidity other than DM. The majority of participants incorrectly answered 19 out of 32 questions of OKT scale. The mean OKT score was 13.5 ± 4.2 indicating poor osteoporosis - related knowledge. Females had significantly higher nutrition (p = 0.037), exercise (p = 0.043), and OKT score (p = 0.021) than males. Regarding OHBS, female participants had significantly higher belief score of susceptibility (p <  0.01) and seriousness (p <  0.01) of osteoporosis compared to males.

CONCLUSIONS

Diabetic patients had poor osteoporosis knowledge and moderate perception of susceptibility and seriousness of osteoporosis. These results require implementation of awareness programs among DM patients to increase their practices regarding preventive measures of osteoporosis such as calcium intake and exercise.

Transgender Individuals and Osteoporosis Prevention

BACKGROUND

Risk behaviors and hormone use place transgender individuals (TIs) in jeopardy for osteoporosis.

PURPOSE

The purpose of this study was to expand the science about the knowledge, health beliefs, and osteoporosis (OP) preventing behaviors of TIs.

METHODS

This was a mixed-methods pilot study of a convenience sample of 31 TIs 30 years and older. Participants completed an online Osteoporosis Bone Health Survey. Fifteen participants were randomly selected for an interview to describe their perceptions of bone health.

RESULTS

Transgender individuals performed poorly on the knowledge measure. There were no significant findings for osteoporosis health beliefs. Participants' daily dietary dairy calcium intake was 800 mg and daily walking activity was 17 minutes. Perceptions of bone health revealed two essential elements, knowing and doing.

CONCLUSION

Determining TIs' bone health perception is important because of their unique healthcare issues. Healthcare providers need to be aware of TIs' bone health needs to help enhance TIs' OP knowledge, health beliefs, and preventing behaviors.

Evaluation of common variants in CNR2 gene for bone mineral density and osteoporosis susceptibility in postmenopausal women of Han Chinese

Postmenopausal osteoporosis is a major health problem with important genetic factors in postmenopausal women. We thoroughly evaluated the relationship of CNR2 polymorphisms with osteoporosis in a cohort of 1032 osteoporosis patients and 2089 healthy controls from Han Chinese postmenopausal women. Statistically significant differences, depending on different genotypes, were presented.

INTRODUCTION

Osteoporosis is a major health problem in postmenopausal women, which is a multifactorial disease in which genetic determinants are modulated by hormonal, environmental, and nutritional factors. An important clinical risk factor in the pathogenesis of osteoporosis is the presence of genetic polymorphism in susceptibility genes. The aim of our study was to investigate whether CNR2 gene, which attributes to osteoporosis susceptibility in some populations, is associated with bone mineral density (BMD) or osteoporosis in Han Chinese postmenopausal women.

METHODS

We examine 39 SNPs covering the region of CNR2 gene in 3121 Han Chinese postmenopausal women, consisting of 1032 osteoporosis patients and 2089 healthy controls, to evaluate the association with BMD and osteoporosis.

RESULTS

We found that rs4237 and rs2501431 were significantly associated with BMD and osteoporosis (corrected p = 0.020085 and 0.017199) in our sample, and the TT genotype of rs2501431 and the AA genotype of rs4237 had lower lumbar spine BMD and femoral neck BMD compared with the other genotypes. Additionally, analyses by haplotypes indicated that two haplotype blocks, containing rs4237 and rs2501431 respectively, in the CNR2 gene significantly associated with BMD and osteoporosis (both global permutation p < 0.001), and a risk haplotype (ATTT) in the block of rs3003336-rs2501431-rs2502992-rs2501432 had almost 4-fold increase in the cases.

CONCLUSIONS

Our results provide further supportive evidence for an important role of CNR2 gene in the etiology of osteoporosis and suggest that it may be a genetic risk factor for BMD and osteoporosis in Han Chinese postmenopausal women.

Osteoporosis-preventive behaviors and their promotion for young men

Osteoporosis in men is a major and neglected public health issue. An experimental study with a sample of 37 young men tested an osteoporosis prevention education intervention to alter osteoporosis health beliefs and to increase osteoporosis-preventive behaviors, in order to determine effectiveness and make public health recommendations. After pretest, control and treatment interventions were administered, with the administration of a posttest 2 weeks later. For all osteoporosis health beliefs and osteoporosis-preventive behaviors measured, no group and time interaction was found to be statistically significant. Both groups had low perceived susceptibility to osteoporosis, low to moderate perceived severity of osteoporosis, high perceived benefits of exercise and calcium to prevent osteoporosis, low perceived barriers to exercise and calcium, and moderate to high levels of confidence in self-efficacy for exercise and calcium. Bouts of exercise per week were adequate; however, consumption of good sources of calcium per day appeared to be low. More research is needed for the promotion of osteoporosis prevention in men. Recommendations promoting preventive behaviors for men have been provided.

Reliability and validity of the revised Osteoporosis Knowledge Test

BACKGROUND AND PURPOSE

The purpose of this study was to test the psychometric properties of the Osteoporosis Knowledge Test (OKT) revised to incorporate recent evidence-based recommendations for bone health.

METHODS

The revised OKT was tested with 866 participants (mean age = 62.8 years +/- 8.5 years) in an online bone health study.

RESULTS

Based on Rasch analysis, there was evidence of internal consistency with an item separation index of 12.68 and a reliability score of .98. The person separation index was 2.06 with a reliability score of .81. The INFIT and OUTFIT mean-square statistics for items on both subscales all demonstrated good fit ranging from 0.71 to 1.40, except for 2 items that had low OUTFIT statistics.

CONCLUSIONS

The revised OKT provides sufficient reliability and construct validity.

WITHDRAWN: Associations between polymorphisms of HLA-B gene and postmenopausal osteoporosis in Chinese Han population

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Associations between polymorphisms of HLA-B gene and postmenopausal osteoporosis in Chinese Han population

Osteoporosis is a systemic skeletal disease, which is more prevalent in postmenopausal women. Osteoporosis likely develops beginning with genetic risk. This study explored the relationships between polymorphisms of HLA-B gene and postmenopausal osteoporosis in a Chinese Han population. Polymerase chain reaction sequence-based typing (PCR-SBT) method was used for DNA typing at HLA-B locus in 70 patients with postmenopausal osteoporosis and 73 healthy controls in female Han population of Shaanxi Province, situated in north-western China. We found that 40 HLA-B alleles in postmenopausal osteoporosis patients and control subjects, respectively. Furthermore, the frequency of HLA-B* 3501 allele was significantly higher in postmenopausal osteoporosis patients than in the control group (P = 0.033), and the relative risk was 7.632 (95% CI: 0.927-62.850). Our results suggest that HLA-B* 3501 was likely an important risk factor for postmenopausal osteoporosis. As different populations have different HLA polymorphisms, further investigation of the relationship of various HLA genes and osteoporosis with larger sample size is still necessary in the future.

Balance control in elderly people with osteoporosis

Osteoporosis is a prevalent health concern among older adults and is associated with an increased risk of falls that incur fracture, injury, or mortality. Identifying the risk factors of falls within this population is essential for the development of effective regimes for fall prevention. Studies have shown that muscle quality and good posture alignments are critical for balance control in elderly individuals. People with osteoporosis often have muscle weakness and increased spine kyphosis leading to vertebral fractures and poor balance control, or even falls. Therefore, improving muscle quality, strengthening weak muscles, and correcting postural alignment are essential elements for the prevention of falls and fractures in older adults with osteoporosis. This review reports the necessary information regarding the critical factors of balance control in older adults with osteoporosis, as well as testing the clinical innovations of exercise training to improve the long-term prognosis of osteoporosis in this vulnerable population.

4q22.1 contributes to bone mineral density and osteoporosis susceptibility in postmenopausal women of Chinese Han population

Osteoporosis is a multifactorial disease in which genetic determinants are modulated by hormonal, environmental and nutritional factors. An important clinical risk factor in the pathogenesis of osteoporosis is the presence of genetics polymorphism in/around susceptibility genes/regions. This study explored whether the region of 4q22.1, which confers risk of developing osteoporosis in some populations, associated with bone mineral density and osteoporosis susceptibility in postmenopausal women of Han Chinese. We investigated 32 SNPs with minor allele frequencies ≥0.05 between 20 kb upstream and 20 kb downstream (40 kb window) of rs6532023, mapping in the 4q22.1 region, which was reported to be significantly associated with osteoporosis in previous studies. We found that rs6532023 was significantly associated with bone mineral density and osteoporosis (corrected p = 0.015) in our sample, including 440 cases and 640 controls, and allele G was supposed as a risk factor while T worked as a protective factor. Further genotype association analyses suggested a similar pattern (corrected p = 0.040). Additionally, analyses by haplotypes indicated that a haplotype block rs7683315-rs6532023-rs1471400-rs1471403 in the region associated with bone mineral density and osteoporosis (global p = 0.032), and risk haplotype A-G-G-C had almost 1.5-fold increased in the cases. To our knowledge, this is the first report to examine 4q22.1 region polymorphisms and osteoporosis in Han Chinese. Our results provide further evidence for an effect of the region of 4q22.1 on the etiology of osteoporosis and suggest that 4q22.1 may be a genetic risk factor for bone mineral density and osteoporosis.