Osteoporosis health beliefs among postmenopausal women with a history of distal forearm fracture

Background: Distal forearm fractures (DFF) are an underrecognized manifestation of osteoporosis. This study investigated osteoporosis health beliefs and preventive behaviors in postmenopausal women with a history of DFF. Methods: A written survey of preventive behaviors (exercise, calcium intake, and osteoporosis medication use) and health beliefs (health motivation, susceptibility to and seriousness of osteoporosis, and barriers and benefits of exercise and calcium intake) was mailed in 1999 to 343 postmenopausal Olmsted County, MN, women who sustained a minimal trauma DFF in 1993 to 1997. X² and Wilcoxon rank sum statistics were used for univariate comparisons, and regression modeling was used to identify predictors of preventive behaviors and health beliefs. Results: A total of 168 women responded, and their mean age was 66 years. There were 98 (60%) women who exercised at least twice per week at moderate intensity, and 114 (68%) took at least 1,200 mg of calcium a day (diet plus supplements). Osteoporosis health beliefs scores (OHBS) were higher for health motivation (76, standard deviation ± 12) than for osteoporosis seriousness (49 ± 16) or osteoporosis susceptibility (48 ± 24). Factors associated with higher osteoporosis susceptibility scores (P < .05) included education less than high school level, prior diagnosis of osteoporosis, prior osteoporotic fractures, densitometry testing after fracture, and adequate calcium intake. Factors associated with health motivation (P < .01) included use of osteoporosis medications, adequate calcium intake, and bone densitometry after fracture. Independent predictors of exercise included exercise benefits (odds ratio [OR], 1.9; 95% confidence interval [CI] 1.1-3.1) and exercise barriers (OR 0.6, 95% CI 0.4-0.9), whereas osteoporosis susceptibility score was the only predictor of adequate calcium intake. (OR 1.5, 95% CI 1.1-2). Conclusion: Over half the women in this cohort exercised at least 2 days per week, and many supplemented their diet with appropriate calcium supplementation. Women's beliefs about the seriousness of osteoporosis or their susceptibility to develop osteoporosis showed lower scores than health motivation, yet women with prior fractures and diagnosis of osteoporosis did have significantly higher susceptibility scores. Exercise barriers and benefits subscales were the most useful predictors of exercise behavior, which may help to identify patients who need more intervention.