Cultural differences in attitudes, values, and beliefs about osteoporosis in first and second generation Japanese-American women

Knowledge and understanding risk factors and preventive measures for osteoporosis in women: results of a survey in 502 women with and without a migration background

BACKGROUND

Osteoporosis is a disease of the skeletal system associated with loss of bone mass and an increased risk of fractures affecting women more often than men. Identification of the knowledge about osteoporosis and its preventive methods is the backbone of any awareness program. This study investigates the knowledge with a special focus on women with and without a migration background.

METHODS

Data from systematic patient interviews based on a questionnaire were collected at three different sites in Berlin between February and June 2021. The survey included questions assessing migrant background, demographic characteristics, lifestyle habits including physical exercise and smoking, prevention by vitamin D intake and bone densitometry, and information on personal and family medical history. According to the responses, a scale was created to assess the level of knowledge of preventive osteoporosis measures. The ethic committee of the Charité, Medical faculty has approved this study. SPSS (version 24.0) was used for the statistical analyses.

RESULTS

The survey of 502 female patients revealed that 25% had low and 34% no previous knowledge of osteoporosis. Older age and a better education level correlate with a higher knowledge. Patients with gynecologic cancer are less well informed. There is a significant difference in vitamin D intake between migrant and non-migrant women (57% vs. 49%). There were no significant differences regarding the use of bone densitometry.

CONCLUSION

Knowledge of osteoporosis and the possibility of a bone densitometry as well as the implementation of preventive measures is low among women. Therefore, informing patients better should be a priority, with particular attention on the risks and needs of women with a migration background. Specific programs for women with and without migration background should be developed to increase the awareness of osteoporosis.

Association between cultural distance and migrant self-rated health

We study whether migrant health in Europe is associated with the cultural distance between their host country and country of origin. To this end, we run multilevel regression models on data merging self-rated health and social background of ≥3800 migrants from the European Social Survey with an index of cultural distance based on country differences in values, norms and attitudes measured in the World Values Survey. We find that higher levels of cultural distance are associated with worse migrant health. This association is comparable in size with the negative association between health and female (compared with male) gender but less important than the association between health and education level. In addition, this association is less significant among second-generation than first-generation migrants.

Knowledge about osteoporosis in a Malaysian population

To determine the depth and sources of knowledge about osteoporosis (OP) among the public in Malaysia. A self-administered questionnaire was distributed to attendees of health-related public forums. A total of 87.1% of the attendees had heard of OP. Of these, 89.5% were concerned about getting OP. Significantly more women than men (P = .015), those with more than 10 years of schooling (P < .001), and those earning more than $US285 per month (P = .022) had heard of OP. Knowledge of OP risk factors was good: 97.1% identified low calcium intake, 87.8% lack of exercise, 80.0% family history of OP, and 75.8% postmenopausal status. A total of 38.7% of the attendees thought that OP was more serious than cancer and 35.1% more serious than heart disease; 55.7% obtained information about OP from newspapers and 46.4% from magazines. In this self-selected population, women, the better educated, and those earning higher incomes were more aware of OP. Knowledge of OP was obtained mainly from printed materials.

Osteoporosis health-related behavior among healthy peri-menopausal and post-menopausal Israeli Jewish and Arab women

BACKGROUND AND AIMS

Health practices such as calcium-rich diet and exercise, are associated with the prevention of osteoporosis. Since studies showed that ethnic minorities are less involved in preventive practices, the aim of this study was to examine patterns and correlates of osteoporosis health-related behavior in Israeli-Jewish and Arab women.

METHODS

Interviews were conducted with 261 women aged 45 and older (70% Jewish). Health behavior included: physical activity, smoking, alcohol consumption, use of hormone replacement therapy, screening behavior, calcium intake, pharmacological prevention, and help-seeking patterns. Correlates included demographic variables, health characteristics (menopausal status, family history of osteoporosis), knowledge about osteoporosis, and beliefs (susceptibility and worries about developing osteoporosis).

RESULTS

Compared with Jewish participants, a lower percentage of Arab women engaged in physical activity, were on HRT, and had had bone density examinations. Their overall calcium intake was significantly lower as well. Levels of knowledge were moderate to low for the whole group, but more so among Arab women. Engaging in physical activities was associated with being menopausal and with having more knowledge among Jewish women, and with having more knowledge and lower rates of concern among Arab women.

CONCLUSIONS

Expanding knowledge about osteoporosis may prove beneficial for increasing participation in preventive behavior in both groups. Special attention should be paid to different levels of education and to differences in subjects' needs and accessibility to sources of information.

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.

Illness attribution among Japanese patients with acute myocardial infarction

OBJECTIVE

The purpose of this study was to describe causal attribution of acute myocardial infarction (AMI) in Japanese patients.

DESIGN

A cross-sectional study design was used.

SETTING

The setting for this study was 5 hospitals in urban areas in Japan.

SAMPLE

A convenience sample of 155 patients admitted with AMI was used.

MEASURES

Causal attribution was assessed by a semi-structured interview. Known risk factors were assessed by medical record review and patient interview.

RESULTS

Twenty-two different primary causes for AMI were identified. Patients most commonly cited smoking, stress, and diet as risk factors. Except for smoking, Japanese patients did not identify their cardiac risk factors as a cause of their AMI. Controlling for sociodemographic characteristics, patients with a recorded history of coronary heart disease were significantly less likely to attribute their cardiac risk factors to their AMI (P <.05).

CONCLUSIONS

Effective education and counseling of patients after an AMI must be coupled with their view of what factors put them at risk for future AMIs.

Osteoporosis health beliefs and practices among Korean immigrants in Nova Scotia

The purpose of this research was to investigate osteoporosis knowledge, as well as health beliefs and practices among Korean immigrants in Nova Scotia. Twenty-six participants (18 women and eight men) completed the questionnaire. The mean age of participants was 48, and their average length of stay in Canada was 14 years. The mean osteoporosis knowledge score was 50% for both men and women and perceived susceptibility to the disease was low, especially in men. Perceived seriousness and health motivation was high relative to perceived susceptibility. Only 62% indicated both that their diet met their nutritional and cultural needs, and changes in dietary and exercise habits since arrival in Canada were reported by 73 and 64%, respectively. This study helped identify existing osteoporosis awareness weaknesses in this population: a). Perceived susceptibility, especially for men; and b). knowledge related to prevention and treatment options, including diet and exercise.

Measuring culture: a critical review of acculturation and health in Asian immigrant populations

The number of studies examining how acculturation affects the health of Asian immigrants has increased in recent years. The proliferation of studies reflects the growing size and heterogeneity of Asian immigrant populations in the United States, Canada, Australia, New Zealand, and the United Kingdom. This paper compares various approaches to acculturation within the health literature on Asian immigrants by reviewing the literature in three-health domains (1) mental health (2) physical health and (3) health services use. The review critically examines the conceptualizations and measures of acculturation in these three domains and presents major findings. We observe that measurement difficulties posed by the experiences of heterogeneous Asian groups compound theoretical and disciplinary disparities between acculturation instruments. The extent to which conceptual and methodological critiques of acculturation studies in Hispanic populations apply to studies of Asian populations is also discussed. The critical review thus provides insights into the diverse ways that the relationship between culture and health is measured in this complicated and growing literature.

Awareness and health beliefs of women towards osteoporosis

A population-based survey was conducted to determine the awareness, knowledge of risk factors, and attitudes toward osteoporosis in middle-aged and elderly women in Singapore. Chinese women aged 45 years and above ( n=1,376) living in Teban Gardens (community on the western side of Singapore) were randomly sampled. Household interviews were conducted and questions on socioeconomic status, knowledge of osteoporosis, identification of risk factors for osteoporosis, and health beliefs were assessed. There were 946 (68.8%) women who were postmenopausal and 430 (31.2%) who were not. Fifty-eight percent of the sample had heard of osteoporosis. Women who were younger, better educated, who exercised regularly, or who were single were more likely to have heard of osteoporosis. The main sources of information about osteoporosis were the mass media and friends. The identification of risk factors ranged from fair to good: 85.7% of women identified low calcium intake, 43.7% identified lack of exercise, and 30.5% identified family history of osteoporosis as risk factors for osteoporosis. Most women (79.1%) were concerned about developing osteoporosis but only 15.2% thought that osteoporosis was more serious than cancer. Community-based health education programs on osteoporosis that target a wide audience including the less well educated, could be implemented. Increasing the awareness of osteoporosis and its risk factors may be essential in efforts to decrease the incidence of this disease.

Asian and Asian-American college students' awareness of osteoporosis

STUDY OBJECTIVE

To quantify Asian and Asian-American college students' knowledge of osteoporosis and preventive health behaviors.

DESIGN

Sixty-four-question survey

SETTING

University of Minnesota.

SUBJECTS

One hundred sixty-eight male and female Asian and Asian-American students, mean age 21 +/- 3.4 years.

MAIN RESULTS

About half of the students consumed 0-1 servings/day of dietary calcium, 42% consumed 2 cups/day or more of caffeinated beverages, 8% smoked cigarettes, and 61% exercised 2.5 hours/week or less. At least 1 serving/day of phytoestrogen was consumed by 80% of the students. Only 11% of students answered at least 75% of osteoporosis fact questions correctly. Women (p = 0.011) and the United States-born participants (p = 0.006) were more apt to change their health behaviors to prevent or treat osteoporosis than men and Asia-born participants. Thirty-eight percent of Hmong participants attributed osteoporosis to fate, chance, or luck whereas Vietnamese participants were more likely to attribute osteoporosis to diet. Most participants (63%) did not know whether their culture objected to estrogen replacement therapy, and 42% said menopause was a natural occurrence for which pharmacologic treatment should not be administered.

CONCLUSIONS

Many Asian and Asian-American college students did not practice health behaviors to prevent osteoporosis, and most lacked sufficient knowledge about the condition.

Knowledge of cardiovascular disease prevention: an analysis from two New England communities

BACKGROUND

Cardiovascular disease (CVD) mortality has been decreasing in the United States, possibly due in part to educational programs about CVD prevention. This study investigates CVD risk-reduction knowledge among demographic subgroups in two New England cities and how the level of knowledge changed in these subgroups over time.

METHODS

Six independent cross-sectional surveys including a series of open-ended recall CVD knowledge questions were conducted biennially from 1981 to 1993 as part of the outcome evaluation for the Pawtucket Heart Health Program. We constructed a raw CVD knowledge score and then created an analysis of variance model with knowledge score as the dependent variable and explanatory variables including demographics, survey, and city.

RESULTS

CVD prevention knowledge improved significantly over time in both cities and in every demographic subgroup, increasing rapidly from 1981 to about 1988 and then plateauing between 1988 and 1993. Adjusted knowledge scores were higher for people born in the United States, women, more educated individuals, and those who spoke English at home. The increase in knowledge over time came mainly from an increase in the identification of physical inactivity, and blood cholesterol/high fat diet as CVD risk factors, while there was a decrease in the identification of overweight and blood pressure.

CONCLUSIONS

In order to assure that reductions in CVD morbidity and mortality will be sustained, national educational efforts which stress behavior change skills as well as knowledge must continue. These programs should focus particularly on higher risk subgroups, and risk factors such as weight reduction and blood pressure control should be special priorities.