Study On Health Education Of Osteoporosis For The Middle-aged And Elderly In Community

Objectives: The purposes of this study were to (1) evaluate the reliability and validity of the Osteoporosis Knowledge Test (OKT), the Osteoporosis Health Belief Scales (OHBS) and the Osteoporosis Self-efficacy Scales(OSES) in testing on a sample of Chinese middle-aged and elderly individuals, so that the Scales would be used in osteoporosis health education as instruments, (2) screen the osteoporosis patients to identify the risk factors of osteoporosis, (3) understand the osteoporosis knowledge, health belief and self-efficacy of the middle-aged and elderly in community to provide evidences of health education and (4) evaluate the effect of osteoporosis health education program to establish the most effective health education model. Subjects: From Aug 2003 to Jan 2004, 291 community dwellers aged from 50 to 97 years (M=65.0+11.3 years) in Nanshitou Street of Haizhu District in Guangzhou City participated in the study.Methods: The revised Chinese version of OKT, OHBS and OSES developed by Kim KK et al and the Health Behaviors Questionnaire designed by the authors were tested on the subjects. And then, 153 of them were tested their lumbar spine and hip bone mineral density. At last, 193 subjects were randomized into three groups according to their diploma and age. The first group (n=64) participated in the education program which included two slide presentations and individual instruction . The second group was given some written materials which included Manual of Osteoporosis Prevention and Treatment, The Study on Exercise Prescription for Primary Osteoporosis, and High Calcium Nutrition Prevents Osteoporosis. The third group was a control group. The above instruments were used in evaluation the effect of health education.Results: (1) The Cronbach's alpha reliability coefficients of the OKT, OHBS and OSES were 0.87, 0.81 and 0. 93 respectively. The test-retest Pearson's correlation coefficients ranged from 0.62 to 0.82 except one item. T test analysis of the difference between 27% higher scores and 27% lower scoresof the OKT demonstrated its discrimination validity very high. The factor analysis indicated that the OHBS and OSES had very high structure validity because the factors were similar to the authors' design. (2) It suggested that low calcium intake, old age, low body mass index and long postmenopausal time were risk factors of osteoporosis. (3) The levels of the osteoporosis knowledge, health beliefs and self-efficacy among the subjects were not high. There were significant differences in the levels in terms of their age, educational background, gender, and occupation. There were significant difference in calcium intake and physical activity in terms of their level of OKT, OHBS and OSES. (4) The health education program was effective in improvement of the OKT, OHBS and OSES. But there was a significant difference in effect on different education model. The combination of slide presentation and individual instruction was better than the written material instruction.Conclusions : (1)The study indicates that the revised Chinese version of OKT, OHBS and OSES is suitable and helpful for osteoporosis health education in the Chinese middle-aged and elderly , but the further research should be done in a wild range age and districts. (2) The osteoporosis health education should be focused on risk factors and susceptible persons. (3) The osteoporosis health education of the subjects who scored low in OKT, OHBS and OSES should be payed attention. (4) The written material instruction may not be an only way of health education, especially in the elderly. Individual instruction is the most suitable way for them. However, health behaviors promotion is a long process which needs development of community health care and participation of all people.