title: Effects of individualized bone density feedback and educational interventions on osteoporosis knowledge and self-efficacy: a 12-yr prospective study.
abstract: This is 12-yr follow-up of a randomized controlled trial aimed to evaluate the long-term effects of bone density feedback and osteoporosis education on osteoporosis knowledge and self-efficacy. We examined the effects of feedback of bone density-defined fracture risk (high [T-score <0] vs normal [T-score ≥0] risk) and 2 different educational interventions (the group-based Osteoporosis Prevention and Self-Management Course [OPSMC] vs an osteoporosis leaflet) on osteoporosis knowledge and self-efficacy in women aged 25-44. Seventy-four percent (N = 347) of 470 participants at baseline participated at 12 yr. Overall, the scores were higher for osteoporosis knowledge but lower for self-efficacy at 12 yr. However, neither intervention had an effect on the change in knowledge (T-score, β = 0.4, 95% confidence interval [CI] = -0.3 to 1.1; OPSMC, β = 0.2, 95% CI = -0.5 to 0.9) or self-efficacy (T-score, β = -1.1, 95% CI = -2.5 to 0.4; OPSMC, β = -0.2, 95% CI = -1.6 to 1.3). Women in households with an unemployed main financial provider had a decrease in knowledge at 12 yr compared with those in households with an employed main financial provider in whom knowledge increased (β = -1.95, 95% CI = -3.40 to -0.50), but there were no other predictors of change identified for knowledge or self-efficacy. In conclusion, beneficial effects of both OPSMC and feedback of high fracture risk on osteoporosis knowledge seen previously at 2 yr were not sustained after 12 yr although overall knowledge was still significantly higher than at baseline. Neither intervention improved osteoporosis self-efficacy. More frequent osteoporosis education and bone density feedback may be required to maintain knowledge, and other approaches to improve self-efficacy are necessary.
authors.affiliation: Menzies Research Institute, University of Tasmania, Hobart, Tasmania, Australia. Electronic address: Feitong.Wu@utas.edu.au.
authors.forename: Feitong
authors.initials: F
authors.lastname: Wu
authors.affiliation: Menzies Research Institute, University of Tasmania, Hobart, Tasmania, Australia.
authors.forename: Laura L
authors.initials: LL
authors.lastname: Laslett
authors.affiliation: Menzies Research Institute, University of Tasmania, Hobart, Tasmania, Australia.
authors.forename: Karen
authors.initials: K
authors.lastname: Wills
authors.affiliation: School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Brian
authors.initials: B
authors.lastname: Oldenburg
authors.affiliation: Menzies Research Institute, University of Tasmania, Hobart, Tasmania, Australia.
authors.forename: Graeme
authors.initials: G
authors.lastname: Jones
authors.affiliation: Menzies Research Institute, University of Tasmania, Hobart, Tasmania, Australia.
authors.forename: Tania
authors.initials: T
authors.lastname: Winzenberg
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D015519:Bone Density; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D010024:Osteoporosis / Q000000981:diagnostic imaging*; D058866:Osteoporotic Fractures / Q000000981:diagnostic imaging / Q000517:prevention & control*; D010353:Patient Education as Topic; D011446:Prospective Studies; D012307:Risk Factors; D020377:Self Efficacy; D011795:Surveys and Questionnaires; D013648:Tasmania / Q000453:epidemiology
keywords: Bone density; education; knowledge; osteoporosis; self-efficacy