title: Women's perspectives and experiences on screening for osteoporosis (Risk-stratified Osteoporosis Strategy Evaluation, ROSE).
abstract: This study aimed to investigate women's perspectives and experiences with screening for osteoporosis. Focus groups and individual interviews were conducted. Three main themes emerged: knowledge about osteoporosis, psychological aspects of screening, and moral duty. Generally, screening was accepted due to life experiences, self-perceived risk, and the preventive nature of screening.
  
  
  OBJECTIVE
  The risk-stratified osteoporosis strategy evaluation (ROSE) study is a randomized prospective population-based trial investigating the efficacy of a screening program to prevent fractures in women aged 65-80 years. It is recommended by the World Health Organization that a set of criteria are met before a screening program is implemented. This sub-study aims to investigate women's perspectives and experiences with the ROSE screening program in relation to the patient-related criteria recommended by the World Health Organization.
  
  
  METHODS
  A qualitative study was carried out involving 31 women by way of 8 focus group interviews and 11 individual interviews. Principles from critical psychology guided the analysis.
  
  
  RESULTS
  Women's perspectives and experiences with the screening program were described by three main themes: knowledge about osteoporosis, psychological aspects of screening, and moral duty. The women viewed the program in the context of their everyday life and life trajectories. Age, lifestyle, and knowledge about osteoporosis were important to how women ascribed meaning to the program, how they viewed the possibilities and limitations, and how they rationalized their actions and choices. The women displayed limited knowledge about osteoporosis and its risk factors. However, acceptance was based on prior experience, perceived risk, and evaluation of preventive measures. To be reassured or concerned by screening was described as important issues, as well as the responsibility for health-seeking behaviour.
  
  
  CONCLUSIONS
  In general, the women accepted the screening program. No major ethical reservations or adverse psychological consequences were detected. Only a minority of women declined screening participation due to a low perceived risk of osteoporosis.
authors.affiliation: Department of Endocrinology, Odense University Hospital, Kloevervaenget 10, 6.sal, 5000, Odense C, Denmark, mette.rothmann@rsyd.dk.
authors.forename: Mette Juel
authors.initials: MJ
authors.lastname: Rothmann
authors.forename: Lotte
authors.initials: L
authors.lastname: Huniche
authors.forename: Jette
authors.initials: J
authors.lastname: Ammentorp
authors.forename: Reinhard
authors.initials: R
authors.lastname: Barkmann
authors.forename: Claus C
authors.initials: CC
authors.lastname: Glüer
authors.forename: Anne Pernille
authors.initials: AP
authors.lastname: Hermann
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008403:Mass Screening / Q000523:psychology*; D010024:Osteoporosis / Q000175:diagnosis* / Q000523:psychology; D010342:Patient Acceptance of Health Care