Structural model for osteoporosis preventive behaviors in postmenopausal women: Focused on their own BMD awareness

Purpose: The purpose of this study was to develop a model that explains causal relationships between post-menopausal women's osteoporosis general knowledge and awareness of their own bone mass density(BMD) and their osteoporosis health beliefs and preventive behaviors. Methods: Retrospective design using structural equation model tested seven variables by using questionnaires of osteoporosis knowledge test, osteoporosis health belief scale, osteoporosis self-efficacy scale, and osteoporosis preventive behaviors scale. 162 middle age and post-menopausal women were recruited. Results: Mediating effect of health beliefs was not significant in the relationship between BMD awareness and preventive behaviors. Instead, BMD awareness had a direct influence on the preventive behaviors that is strong and significant. Between the relationship of the BMD awareness and health beliefs, direct pathways of perceived threat, relative benefits, and self-efficacy were not significant. However, relative benefits and self-efficacy showed direct influence on the preventive behaviors. Conclusion: Having middle age women get their BMD test done in order for them to be aware of their own BMD results might be a critical strategy to promote osteoporosis preventive behaviors. There is a need to develop diverse strategies to enhance their self- efficacy which has been shown to be important to osteoporosis preventive behaviors.