Concern and risk perception: effects on osteoprotective behaviour

Abstract

This study aimed to determine the effect that level of concern for osteoporosis, as well as self-perceived risk of osteoporosis and fracture, has on supplementation use, seeking medical advice, bone mineral density (BMD) testing, and antiosteoporosis medication (AOM) use. Study subjects were 1,095 female Australian participants of the Global Longitudinal study of Osteoporosis in Women (GLOW) untreated for osteoporosis at baseline. Study outcomes from self-administered questionnaires included calcium and vitamin D supplementation, self-reported seeking of medical advice regarding osteoporosis, BMD testing, and AOM use in the last 12 months at the late assessment. Logistic regression was used in the analysis. Concern significantly increased the likelihood of seeking medical advice and, however, had no significant impact on screening or treatment. Heightened self-perceived risks of osteoporosis and fracture both significantly increased the likelihood of seeking medical advice and BMD testing while elevated self-perceived risk of fracture increased AOM use. Supplementation use was not significantly associated with concern levels and risk perception. Concern and risk perceptions to osteoporosis and fracture were significantly associated with certain bone-protective behaviours. However, the disconnect between perceived osteoporosis risk and AOM use illustrates the need to emphasize the connection between osteoporosis and fracture in future education programs.

Figure 1

Percentage of risk perception to osteoporosis* and facture* by differing levels of concern about osteoporosis^∧ and risk^#. *Risk perception to osteoporosis (how would you rate your own risk of “getting osteoporosis” compared to other women your age?) and risk perception to fracture (how would you rate your own risk of fracturing or breaking a bone compared to other women your age?) were each assessed using 5-point Likert scales (i.e., much lower, a little lower, about the same, a little higher, or much higher) [12]. ^#For this study: higher risk = “a little higher” or “much higher”. ^∧Concern about osteoporosis (in thinking about your health, how concerned are you about osteoporosis?) was assessed using a 3-point Likert scale (i.e., very concerned, somewhat concerned, and not at all concerned) [12].

Figure 2

Percentage of perceived fracture risk* among untreated^∧ respondents diagnosed^# with osteoporosis. *Risk perception to fracture (how would you rate your own risk of fracturing or breaking a bone compared to other women your age?) was each assessed using 5-point Likert scales (i.e., much lower, a little lower, about the same, a little higher, or much higher) [12]. For this study: lower risk = “much lower” or “a little lower”, about the same = “about the same,” and higher risk = “a little higher” or “much higher”. ^∧Treatment was defined asself-reported use of antiosteoporosis medications (i.e., estrogen, selective estrogen receptor modulators, bisphosphonates, calcitonin, parathyroid hormone, and strontium). ^#Self-reported osteoporosis (answer “yes” to “has a doctor or health provider ever told you that you had osteoporosis?”).