Impact of health beliefs and risk perception on willingness to undergo osteoporosis assessment among perimenopausal and menopausal women in primary care: a descriptive cross-sectional study

Abstract

Background: Osteoporosis holds significant clinical importance as a major risk factor for fractures and the associated consequences of chronic pain, disability, loss of independence, decreased quality of life, and increased mortality. Studies have found varied levels of knowledge, risk perception and health beliefs about osteoporosis. The impact of health beliefs and risk perception on willingness to undergo osteoporosis assessment was not known. This study thus aimed to determine the factors that impact the willingness of peri-menopausal and menopausal women to undergo Bone Mineral Densitometry for osteoporosis assessment.

Methods: The study was a descriptive cross-sectional study utilising self-administered questionnaires. Women aged 50 years and above were recruited via convenience sampling from a cluster of public primary care clinics in Singapore. The Osteoporosis Health Belief Scale (OHBS) was modified with permission for local context with good validity and reliability. The modified OHBS had 19 items in five subscales: perceived susceptibility to osteoporosis (risk perception), benefits and barriers to calcium intake, and benefits and barriers to exercise. Logistic regression was used to determine the predictors that impacted willingness to undergo osteoporosis assessment.

Results: Of 342 women who participated in the study, the mean age was 62.29 years, most were Chinese (75.3%), married (85.3%) and had secondary education (53.4%). Only 15.2% had a family history of osteoporosis and 10.9% were classified as high risk for osteoporosis. Two-thirds of participants (66.1%) were willing to undergo osteoporosis assessment. Logistic regression found that women of Chinese ethnicity, older age, history of fractures and those with higher risk perception and exercise benefits scores were more likely to be willing to undergo osteoporosis assessment.

Conclusion: The study highlighted pertinent sociodemographic and clinical factors as well as risk perception and health beliefs that impacted willingness to undergo osteoporosis assessment. Knowledge of these factors will be useful when developing interventions to improve preventive behaviours for osteoporosis and increase uptake of osteoporosis assessment for those at risk.

Keywords: Health beliefs; Menopausal women; Osteoporosis assessment; Risk perception.