Study Of The Effect Of The Osteoporosis Health Education Based On The Health Belief Modle To Middle-aged And The Elderly

ObjectivesTo investigate the level of the middle-aged and elder's osteoporosis(OP) knowledge,OP health belief and OP self-efficacy as well as the behaviors and available rescoures for OP prevention.Design and evaluate the tailored OP health education method which is based on Health Belief Modle(HBM)by analyzing the factors related to the prevention behaviors of OP to provide scientific proofs for the better OP health education in future.MethodsA epidemiology quasi-experiment design was conducted among the convenient sample of 300 middle-aged and the elderly aged 40 and above enrolled from Tianjin during April to November,2008.Subjects were divided into two groups according to their living place.All of the participants were requested to finish the baseline questionnaire before the intervention.The control group would have a health education on OP after they finished the baseline questionnaires whereas the intervention group would been given the tailored education after analyzing the factors related to the prevention behaviors of OP by using Logistic Regression Analysis and subject's self-report demonding knowledge.Evaluation questionnaires were administered to all of subjects at 3 months follow-up to evaluate the changes of their level of OP knowledge,OP health belief and OP self-efficacy as well as the preventive behaviors.Descriptive statisic,t test,Chi-square test and logistic regression were performed throughout the research.Results1.More than half of subjects(64.54%)have good dietary habit for OP prevention.However,little participants have exercise and sun light exposure that is suitable to prevent OP,the awareness of OP prevention are also inadequate:the percent of suitable exercise,enough sun light exposure,previous BMD test,calcium tablet and medicine intake for the prevention of OP are only 15.25%,31.20%,12.41%,20.92%and 1.77%respectively.2.The possession of resources for OP prevention is insufficient,especially the support from medical staff. 3.OP knowledge is prevalent absent among the subjects:correct rate are only 44.08%and 48.08%in women and men;in addition,subjects are in low OP health belief level:the average score total of health belief is only 144.98±13.66 and 3.45for each item(in the level of 'neutral').However,the self efficacy of paticipants are in upper middle level(with score of 80.91 for total and 6.74 for each items).4.The factors related to the prevention behaviors of OP are analyzed based on HBM by using logistic regression:①factors related to dietary habit are gender (OR=0.247,p=0.000),age(OR=1.060,p=0.000),media accessibility(OR=2.805,p =0.000),barriers to calicium(OR=1.010,p=0.026) and health belief(OR=1.036,p =0.001).②barriers to exercise(OR=1.302,p=0.000) is the unique factor related to suitable exercise.③factors related to sufficient sun light exposure are:history of facture(OR=2.594,p=0.012),media accessibility(OR=1.913,p=0.023),exercise knowledge score(OR=1.189,p=0.034),barriers to exercise(OR=1.090,p=0.010) and OP history of one's relatives and/or friends(OR=2.188,p=0.026).④available resources for OP prevention(OR=1.401,p=0.049),media accessibility(OR=2.323,p =0.024),perceived susceptibility(OR=1.063,P=0.037)and calcium efficacy(OR=1.026, p=0.039) are associated with calcium tablet intake.5.The two education methods are all able to help the subjeces to improve their OP knowledge level,part of OP health belief and calcium efficacy;However,the tailored education based on HBM is better in improving subjects' OP knowledge level, perceived susceptibility,barriers to calcium,health motivation and the total level of health belief as well as the adoption of dietary habit and sun light exposure.ConclusionImproving the accessibility of available resources for OP prevention,especially supports from medical staff should be stressed in future OP prevention programmes. Health education can help the the middle-aged and the elders prevent OP;the tailored education based on HBM is more effective.Reasonable and effective exercise plans for people with chronic disease need to be developed to help them avoid OP.