Psychometric properties of the Malay version of the Osteoporosis Health Belief Scale (OHBS-M) among Type 2 diabetic patients

Development and Validation of the Osteoporosis Knowledge, Attitude, and Behaviors Questionnaire for Female Osteoporosis Patients in Taiwan: A Mediation Model

This research develops the Osteoporosis Knowledge, Attitude and Behaviors Questionnaire (OKABQ) with the intent to evaluate the levels of osteoporosis knowledge, attitude and behavior change by developing and validating the OKABQ while establishing a mediation model of the research. A quantitative, descriptive and instrumental study was conducted in two phases: Phase I—development of the scale through Delphi Method by osteoporosis experts; and Phase II—evaluation of the validity and reliability of the scale and construction of a mediation model using SmartPLS. In Phase I, the content validity index (CVI) of the questionnaire was higher than 0.96 and the inter-rater reliability (IRR) kappa was 1.00. In Phase II, exploratory factor analysis showed that two predominating factors of attitude as a mediation were addressed by the 26-item OKABQ. The indirect effect results from the estimated model indicate that attitude mediates the relationship between knowledge and behaviors (β = 0.114, t = 2.627, p < 0.001), which is positive and statistically significant. We concluded that the OKABQ is a valid measure of osteoporosis knowledge, attitudes and behaviors for women with osteoporosis. These assessment results could assist healthcare providers in mitigating insufficiency in health education and help patients better adapt to a more active bone-healthy lifestyle.

Osteoporosis Knowledge and Health Beliefs Among Female Community Leaders in Peru

Background: Osteoporosis presents an increasing problem globally, primarily affecting older adults and postmenopausal women. Among important modifiable risk factors for osteoporosis, physical activity and calcium intake help reduce bone mineral loss and decrease the prevalence of osteoporosis. Although osteoporosis knowledge and health beliefs are associated with adopting preventive behavior and screening rates, few studies have evaluated them in Latin American populations. Materials and Methods: We conducted a cross-sectional study among female community leaders in a Peruvian periurban setting. A total of 60 women participated in the study, with a mean age of 43.7 ± 8.3 years, mean body mass index of 30.4 ± 5.3 kg/m², 88% being overweight or obese, and 58.3% having completed high school education or beyond. Participants completed translated and culturally adapted Osteoporosis Knowledge Test and Osteoporosis Health Belief Scale via semistructured interviews. Results: Most participants reported high knowledge regarding osteoporosis, perceived benefits to exercise and calcium intake, and health motivation. The level of osteoporosis knowledge was highly associated with the level of education, and we found a trend for the association between level of knowledge and perceived benefits of exercise and barriers to calcium intake among participants. Conclusions: Female community leaders with high health motivation and community engagement can contribute enormously to osteoporosis prevention programs in local communities in the future.

A comprehensive view of knowledge and osteoporosis status among type 2 diabetes mellitus in Malaysia: A cross sectional study

Background:

osteoporosis and diabetes mellitus are highly prevalent diseases that have potentially devastating effects on health and socioeconomic status.

Objective:

The aims of this study were to assess: 1) the level of osteoporosis knowledge among T2DM patients; 2) the correlation, associations or differences of demographic characteristics, diabetes-related variable, as well as, lipid and blood pressure profiles with osteoporosis knowledge; and 3) the correlation between T-score measurement using quantitative ultrasound scan (QUS) and osteoporosis knowledge.

Methods:

A cross-sectional study design was chosen, where data was collected using a self-report structured questionnaire using osteoporosis knowledge - Malay version questionnaire (OKT-M) among T2DM patients. Furthermore, the clinical data regarding the patients were collected retrospectively from the hospital medical record after patient interview was completed.

Results:

The average age of the patients was 62.67 (SD 9.24) years (ranged from 33 to 87 years). Males (231, 51.30%) slightly outnumbered females. Among the racial distribution, the proportion of Chinese patients (204, 45.30%) was higher than Malay (127, 28.20%) and Indian patients (119, 26.40%). In addition, more than three quarters (343, 76.20%) of patients had poor glycaemic control. The average OKT-M total score, OKT-M Exercise subscale and OKT-M Calcium subscale were 12.55 (SD 4.06), 8.60 (SD 2.89) and 8.40 (SD 3.36), respectively. Only 33.30% of the T2DM patients were found to have high level of osteoporosis knowledge. There was a lack of identification and recognition of osteoporosis risk factors. There were significant differences or associations between osteoporosis knowledge and education level, monthly income, employment status, family history of fracture, smoking habit, alcoholic status, insulin use, therapy type and diastolic blood pressure. In addition, significant and positive correlations were found between T-scores and OKT-M total score (n=450, rs= 0.244, P=0.000), OKT-M Exercise subscale (n=450, rs= 0.219, P=0.000) and OKT-M Calcium subscale (n=450, rs=0.199, P=0.000) among T2DM patients (all Ps<0.05).

Conclusions:

Overall, the study results showed a valuable insight into the knowledge toward osteoporosis, as well as its relation to the bone loss among T2DM patients. It is important to understand the basics of osteoporosis prevention behaviours such as adequate calcium intake and regular exercise which are essential to build and maintain healthy bones throughout life among T2DM.

Cross-Cultural Adaptation and Psychometric Properties of Osteoporosis Knowledge Tool-Arabic Version Among Iraqi Population

Background:

Osteoporosis is a major public health problem as the majority of people are not aware of the disease until the complications occur.

Objective:

The aims of this study were to validate Osteoporosis Knowledge Tool (OKT-A) Arabic version and to assess the osteoporosis knowledge among Iraqi general population.

Methods:

A descriptive, cross-sectional study was carried out in the city of Baghdad with a random cluster sampling method from the community. Forward–backward-forward translation method was used to translate the OKT questionnaire from English into Arabic language. The psychometric assessment process includes: face validity, reliability (Cronbach’s alpha and test-retest), item difficulty index, point biserial correlation and discriminatory power.

Results:

The results showed good face validity. The Cronbach’s alpha and Pearson correlation coefficient of the test re-test reliability were 0.775 and 0.412, respectively. Item difficulty index, point biserial correlation ranges and discriminatory power were 0.105 to 0.852, 0.105 to 0.445 and 0.933, respectively. These results demonstrated that OKT-A was a reliable and stable tool. The results showed low OKT-A scores 11.50±3.958. Furthermore, the OKT-A scores and its subscales were less than 50%. In addition, there were significant differences between the following independent variables in relation to total OKT-A scores: educational level, do you have osteoporosis or ever heard about osteoporosis. Moreover, there was a significant association between ever heard about osteoporosis groups and the OKT-A knowledge levels.

Conclusion:

This study showed good validity and reliability of OKT-A tool among Arabic general population. In addition, the results showed an urgent need for implementing an educational programme and should be a public health practice to increase the knowledge toward osteoporosis and its related risk factor.

Validation and Assessment of Osteoporosis Self-Efficacy Among Iraqi General Population

Background

Poor quality of life, fractures and disability are the consequences of preventable osteoporosis.

Objectives

The aims of this study were to validate and assess Osteoporosis Self-efficacy Scale (OSES-A) Arabic version among Iraqi general population.

Methods

A cross-sectional study with a random cluster sampling method from the community was used. Forward-backward-forward translation method was used to translate the questionnaire from English to Arabic. Beside OSES-A, Osteoporosis Knowledge Tool (OKT) and Osteoporosis Health Belief Scale (OHBS) Arabic versions were used to assess osteoporosis preventive behaviours.

Results

The results showed good face validity and reliability. The construct validity showed two factors which explain 80.86% of the variance. In addition, the result showed low self-efficacy score (658.43±222.014) with 83.33% were found to have low OSES-A level. There were significant associations between age, gender, and self-reported osteoporosis with OSES-A levels. In addition, there were significant differences between age, gender, marital status, family history of osteoporosis, self-reported osteoporosis and osteoporosis diagnosis or screening in relation to total OSES-A scores. Moreover, there were positive correlations between the OSES-A total score with total knowledge and health belief. Multivariate analysis revealed that OKT levels, OHBS levels, age and gender were predictors for OSES-A levels.

Conclusion

This study showed good cultural adaptation and psychometric properties of OSES-A tool and could be used in any osteoprotective educational program.

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.

Psychometric properties and assessment of the Osteoporosis Health Belief Scale among the general Arabic population

BACKGROUND

Any educational program should be implemented with a good understanding of the population's beliefs. Therefore, the aims of this study were to validate the Arabic version of the Osteoporosis Health Belief Scale (OHBS-A) and assess the osteoprotective attitude among the Iraqi population.

METHODS

A cross-sectional design, with a random cluster sampling method from the community, was used. The forward-backward-forward translation method was used to translate the questionnaire from English to Arabic. In addition, the Arabic version of Osteoporosis Knowledge Tool (OKT-A) and the Arabic version of Osteoporosis Self-Efficacy Scale (OSES-A) were used to assess the osteoprotective behaviors.

RESULTS

The results showed good face validity and reliability. The construct validity analysis showed seven factors that explain 72.82% of the variance. In addition, the results revealed a low health belief score (149.95±35.936) with only 36.67% of the study population found to have a high OHBS-A level. The results showed significant differences among employment status, marital status, and osteoporosis (OP) awareness groups in relation to total OHBS-A scores. In addition, there were significant associations between age groups and OP awareness with health belief levels. Moreover, both exercise and calcium intake subscales of the Osteoporosis Knowledge Tool (OKT) positively correlated with all OHBS-A subscales. Exercise and calcium intake subscales of Osteoporosis Self-Efficacy Scale (OSES) positively correlated with the perceived susceptibility and perceived barriers toward exercise and calcium intake. The binary logistic regression analysis showed that OKT levels, OSES levels, and age were predictors of OHBS-A levels.

CONCLUSION

Besides cultural obstacles, an educational program for both genders and all age groups is important and should be tailored according to culture needs.

Assessing health beliefs about osteoporosis among women attending primary health care centres in Qatar

Objective

Osteoporosis is a global health problem, and its prevalence is rapidly increasing worldwide. Misconceptions about osteoporosis and the lack of preventive measures among women are still common, emphasizing the need for primary prevention at an early age. The process of planning an effective osteoporosis prevention programme requires sufficient information about women's osteoporosis health beliefs. The objective of this study is to assess the health beliefs of 20–44 year-old Arab women about osteoporosis at primary health care centres in the State of Qatar.

Methods

The researchers utilized a cross-sectional study design, where cluster sampling with proportionate allocation was employed to enrol 766 eligible women who were interviewed using a structured Arabic questionnaire.

Results

The majority of the participating women showed lower perceived susceptibility to osteoporosis (71.7%) but higher perceived benefits of preventive practices (91.7%).

Conclusion

Despite lower perception of susceptibility to osteoporosis, women were highly motivated to take care of their health and believed in the benefits of a calcium-rich diet and regular exercise. The integration of osteoporosis prevention into women's health programmes at the primary health care level, as well as physical activity and nutritional programs, are recommended.