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Young Women Are Not Adhering to Osteoporosis Prevention Programs

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Young Women Are Not Adhering to Osteoporosis Prevention Programs

John Allegrante

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In the first cross-sectional study of 321 women to assess osteoporosis knowledge, beliefs, and preventative behaviors-86 percent of the survey participants had heard of osteoporosis, but only 3 percent of the respondents reported getting both adequate exercise and the recommended calcium intake.

The study was a joint project of John Allegrante, Professor of Health Education at TC, Mark J. Kasper of the Department of Kinesiology and Physical Education, Valdosta State University, and Margaret G. E. Peterson of the Department of Biomechanics and Biomolecular Modeling, Hospital for Special Surgery, New York. The study was titled, "The Need for Comprehensive Educational Osteoporosis Prevention for Young Women: Results From a Second Osteoporosis Prevention Study." It was published in Arthritis Care & Research (45:28-34,2001).

In a previous study by the same research group, 127 college women were surveyed concerning osteoporosis prevention. That report was the first to document the lack of knowledge of risk factors, inadequate dietary and exercise behaviors, and the perception of low risk for developing osteoporosis among young women. However, more than 90 percent of the respondents in the study were white, making it difficult to determine whether racial differences exist.

The current sample was more racially diverse (29 percent black vs. 7 percent black) and was drawn from a different geographic location (southeastern vs. midwestern United States).

Nevertheless, both studies are consistent in the following major areas and point to the need for osteoporosis prevention programs.

First, fewer than 7 percent of young women were getting sufficient exercise and the recommended dietary calcium intake to build healthy bones.

Second, heath care providers and educational institutions have missed opportunities or failed to disseminate osteoporosis information to young women.

Third, the vast majority of women were able to identify the risk factors of lack of exercise and low calcium intake but few were able to identify the risk factors of early menopause, post menopause status, or menstrual irregularities.

Fourth, women were somewhat concerned about developing osteoporosis, but they were much more concerned about and believed that they were much more likely to develop heart disease and breast cancer. They also believed that heart disease and breast cancer are more serious than osteoporosis and that one is less responsible for developing osteoporosis than for developing heart disease.

Fifth, respondents' beliefs about osteoporosis were not related to their exercise habits, calcium intake, or knowledge about osteoporosis.

Both studies reveal that knowledge alone was not sufficient to influence osteoporosis prevention for young women. "Intervention by health care providers," according to the researchers, "needs to be embedded in a larger, supportive system that addresses the predisposing, enabling, and reinforcing factors at the individual, organizational, and community level."

The researchers conclude the study with this dire prediction for osteoporosis prevention unless a comprehensive educational program is developed: "Over the next decade osteoporosis will cost two million people years of functional impairment and $45 billion in direct medical costs. Our data suggest that young women are en route to adding to this burden. Coupled with a greater proportion of our population surviving to older age, osteoporosis is becoming a public health concern. Development and evaluation of comprehensive educational programs should be a high priority."

In a related initiative, Professor Allegrante has just received (as we go to press) a $315,241 grant from the National Institute of Arthritis and Musculoskeletal and Skin Diseases for a five-year program of research aimed at improving the functional outcome for over 250,000 people who fall and fracture a hip each year.

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