Increasing Osteoporosis Knowledge Among College Women using the Health Belief ModelChelsea Hewitt

Health Belief Model History

• Initial Development in the 1950’s by social psychologist Hochbaum, Rosenstock and Kegels in the U.S. Public Health Service•One of the earliest health behavior theories• It was later expanded to study peoples response to symptoms and diagnosed illness

Health Belief Model History• Stimulus Response Theory (Waston, 1925)• learn new behaviors and/or change old behaviors because of consequences• Skinner, 1938•Cognitive Theory (Lewin, 1951)

Health Belief Model History•Has been one of the most widely used theoretical frameworks in research on health behavior since the 1950’s •HBM has been expanded and used to support interventions

HBM Constructs

• Perceived Susceptibility• Perceived Severity• Perceived Benefits• Perceived Barriers•Cues to Action• Self-Efficacy

Modifying Factors

•Media•Health professionals• Personal relationships• Incentives• Self-efficacy of recommended health action

Health Belief Model

Concept  Definition  Application

Perceived Susceptibility

One's opinion of chances of getting a condition

Define population(s) at risk, risk levels; personalize risk based on a person's features or behavior; heighten perceived susceptibility if too low

Perceived Severity

One's opinion of how serious a condition and its consequences are

Specify consequences of the risk and the condition

Perceived Benefits

One's belief in the efficacy of the advised action to reduce risk or seriousness of impact

Define action to take; how, where, when; clarify the positive effects to be expected

Perceived Barriers

One's opinion of the tangible and psychological costs of the advised action

Identify and reduce barriers through reassurance, incentives, assistance

Cues to Action

Strategies to activate "readiness"

Provide how-to information, promote awareness, reminders.

Self-EfficacyConfidence in one's ability to take action

Provide training, guidance in performing action

Osteoporosis

•Osteoporosis, or "porous bones," causes bones to become weak and brittle — so brittle that a fall or even mild stresses like bending over or coughing can cause a fracture. In many cases, bones weaken when you have low levels of calcium and other minerals in your bones.

Early Prevention

• In order to prevent and delay the onset of osteoporosis in the later part of life, prevention methods need to begin many decades before menopause•Education on prevention methods is a major component

Kasper, M.J., Peterson, M.G., Allergrante, J.P., Galsworthy, T.D., & Gutin, B. (1994) Knowledge, beliefs, and behaviors

among college women concerning the prevention of osteoporosis. Arch Farm Med, 3, 696-702.

•Objective - To access college age women's knowledge on osteoporosis risk factors and their beliefs about the disease.• They also looked how they practiced preventative behaviors already.

• Completed questionnaire with a 100% response rate

Kasper, M.J., Peterson, M.G., Allergrante, J.P., Galsworthy, T.D., & Gutin, B. (1994) Knowledge, beliefs, and behaviors

among college women concerning the prevention of osteoporosis. Arch Farm Med, 3, 696-702

• Results - 114 heard about osteoporosis• Only 49 of that 114 had received information from

school or a health care provider• There was a significant relationship between receiving

osteoporosis information and being able to identify risk factors

• Only 6.7% of the women reported getting the appropriate exercise requirement to protect against osteoporosis and getting the recommended 1200mg of calcium per day

Comments

• The study found that educational institutions and health care providers are not providing information about osteoporosis to young women or the information has not been received and retained by the women

Limitations• Small sample size• Self reporting data

Sedlak, C.A., Doheny, M.O., Jones, S.L. (2000). Osteoporosis education programs: Changing knowledge and behaviors. Public Health Nursing,

17(5), 398-402.• Goal - to describe the type of program that

would change knowledge, health beliefs, and behaviors for women with different needs and backgrounds about osteoporosis risk factors• 3 educational programs• Varied in length and method of presenting

content• Completed survey before and 3 weeks after

program• Each program had a different “intensity” level

Conclusion• Survey completed 3 weeks after program• Results• Impact of program on health beliefs• Only difference was the participants in the

intermediate group increased their beliefs that calcium intake was beneficial for prevention of osteoporosis

• Impact of osteoporosis preventing behaviors• Participants in the intense group reported that

they significantly decreased their intake of caffeine

• Impact of program on knowledge• Participants of all programs had significantly

higher levels of knowledge posttest

Discussion

• All programs increased knowledge about osteoporosis prevention, regardless of program design• Overall, all programs did not change

the participant’s health beliefs about osteoporosis or increase their prevention behaviors• Further programs are needed to

access how women's health beliefs help them engage in long-term osteoprevention behaviors.

Osteoporosis knowledge and educational program in the Greek community at University of Alamabama• Purpose of the study would be to test the women’s knowledge on osteoporosis and provide information on what they can start doing during their college years to prevent or delay the onset of osteoporosis when they get in their 50’s 60’s and 70’s

Osteoporosis knowledge and prevention program in the Greek community • Recruit 30 women from 18 sororities

Panhellenic and Pan-Hellenic• Women will take an initial survey• Questions will cover the 6 constructs

• Complete 5 group sessions that will directly follow their chapter meetings• There will also be a make-up meeting on

another night during the week if girls are not able to make the original

• During the final class the girls will take the original survey to test what they have learned

Sample Survey Questions

• Do you believe you are at risk for getting osteoporosis in the future? Yes No Don’t know

• Does osteoporosis run in your family? Yes No Don’t know

• Do you engage in 30 minutes of weight-bearing exercise 3 days a week? Yes No Don’t know

• Do you believe calcium consumption is beneficial to prevent the onset or delay osteoporosis? Yes No Don’t know

• Does consuming excess amounts of caffeine increase the onset of osteoporosis? Yes No Don’t know

• Do you believe you are susceptible to getting osteoporosis in your postmenopausal years? Yes No Don’t know

• Do you believe you are knowledgeable on ways to prevent osteoporosis later in life? Yes No Don’t know

Discussion• Limitations• The program only includes Greek affiliate

women• The surveys are self reported• Possibility of women missing sessions

because of conflict• Even though the program only reaches a small

amount of the entire sorority population, the women will be knowledgeable about osteoporosis and be able to take the information they learn in the program and, hopefully, share it with other members of their chapter

Discussion

• The severity of osteoporosis needs to be taught to women before they are diagnosed with this deadly disease• The Health Belief Model is ideal for this program because college age women are not statistically shown to perceive osteoporosis as a threat• Our main goal is to increase perceived susceptibility and the severity of osteoporosis to the women since they are at such a crucial age where it is most important for them to know all the facts about osteoporosis

References• Glanz, K., Rimer, B.K., Viswanath, K. (2008) Health

Behavior and Health Education: Theory, research, and practice. San Fransisco: Jossey-Bass.

• Kasper, M.J., Peterson, M.G., Allergrante, J.P., Galsworthy, T.D., & Gutin, B. (1994) Knowledge, beliefs, and behaviors among college women concerning the prevention of osteoporosis. Arch Farm Med, 3, 696-702.

• Sedlak, C.A., Doheny, M.O., Jones, S.L. (2000). Osteoporosis education programs: Changing knowledge and behaviors. Public Health Nursing, 17(5), 398-402.

• Turner, L.W., Hunt, S., Dibrezzo, R., & Jones, C. (2004). Design and implementation of an osteoporosis prevention program using the Health Belief Model. American Journal of Health Studies

References• Noar, S.M. (2005) Ahealth educator’s guide to

theories of health behavior. Int’l Quarterly of Community Health Education, 24(1), 75-92.