Intervention Helps Increase Knowledge, Decrease Risks Of Osteoporosis If Women Change Beliefs, Behavior

FAYETTEVILLE, Ark. - Educational intervention can help women improve their bone health and reduce their risk for osteoporosis, University of Arkansas researchers found - unless the women are reluctant to change their behavior because of their beliefs.

In fact, in pursuing their study, the UA researchers found an adamant minority of women whose beliefs about health care and nutrition made them resistant to intervention and put them at grave risk for developing the debilitating disease.

"There exists a vocal group of women who are very anti-physician," said Lori Turner, associate professor of health science and lead author of the study. "They think doctors are evil, and medicine is poison - that even dairy is poison."

Turner and Ches Jones, also an associate professor of health science, authored the study, "Osteoporosis Knowledge, Attitudes and Behaviors of Women Participating in an Osteoporosis Prevention Intervention." Turner also designed the intervention program within it. Research assistant Blake Perry contributed. Turner and Jones presented their research at the 7th World Conference on Injury Prevention and Safety Promotion held June 6-9 in Vienna, Austria.

"The goal was to see if we could increase the participants' knowledge and perhaps modify their behaviors and modify their beliefs through intervention, and if so, this might be a good model to use elsewhere," Jones said.

The researchers found a high percentage of women in one study initially had low bone density readings - but many improved their bone health after participating in an osteoporosis prevention intervention.

However, about 20 of the women actually had lower bone density readings at the conclusion of the study, because they didn't change their behavior to include more bone-healthy food choices and less risky behavior.

Most surprising to Turner was that these were mostly educated women. Some of them had low initial bone density readings but didn't change their behaviors after being told of their low readings. As a result, their readings dropped even lower upon follow-up, showing a direct relationship between behavior and bone density.

According to Turner, some of these women were adamantly opposed to going to a doctor, but would instead trust every aspect of their health solely to the claims of health food store products and practitioners of alternative medicine. The education intervention included information to help consumers determine whether such claims were true or false, but the information did not help the women who did not use it.

"It was tough when we're trying to help them," Turner said.

Turner and Jones' study involved 342 women between the ages of 30 and 64 years. The women were surveyed on their knowledge, attitudes and behavioral risk factors relating to osteoporosis. They then attended four classes where they gained information and knowledge about the disease and what they could do to reduce their risk for it. The classes were on osteoporosis risk factors, nutrition, supplements and physical activity.

The women also underwent hip and spine bone mineral density testing, followed by individual consultations.

"Out of the sample of 342, about 105 women had below-normal readings," Turner said. "We're talking about middle-aged women - that's more than I'd expected out of a population that basically has good health behaviors."

When the 342 women were resurveyed after the intervention, many showed increased consumption of dairy products, calcium-rich foods and calcium supplements. Some had increased their activity levels or changed behavior that put them at risk for osteoporosis.

"There was a significant change for the better," Turner said.

She was pleasantly surprised by the overall level of enthusiasm and participation among the women. Of the 369 who initially signed up for the sample group, 342 of them, or 93 percent, completed the program.

Turner noted that, in the intervention classes, instructors emphasized the disfiguring aspect of osteoporosis as a way to get the women's attention.

"Especially with women, if a disease involves disfigurement, it becomes more of a threat," she said. "That's why breast cancer can be so scary, because it can be disfiguring."