Effect of Health Belief Model-Based Osteoporosis and Fall Prevention Program on Early Old-Aged Women

Purpose:  Osteoporosis is globally affecting the health of people, especially menopausal women. Decreased amount of estrogen during menopause causes loss of bone mass leading to bone fractures. International Osteoporosis Foundation (IOF) (2015) reports 1 in 3 menopausal women are at risk of osteoporotic fractures. One of the typical sites of osteoporotic fracture is at proximal femur and hip fracture is known to increase the risk of mortality rates by 10% to 20% (Miller, 2016; Buttaro, Trybulski, Bailey, & Sandberg-Cook, 2013). Fracture of the hip can be a burden both at an individual and social level because its treatment requires longer hospital stays than any other common chronic illnesses (IOF, 2015). Long hospital stays due to osteoporotic fractures are costly and can be prevented by early identification (Hopkins et al., 2016; Solomon et al., 2014). Due to asymptomatic feature of the disease until fracture develops, higher mortality rates by bone fractures, and great expense followed by its complication treatment, it is important to prevent osteoporosis and fall among population at the most risk group. The purpose of this study is to determine whether Health Belief Model (HBM)-based Osteoporosis and Fall Prevention Program has an impact on the level of osteoporotic/fall related knowledge, self-efficacy on physical activities and diet change, and preventive behaviors among women aged 65 to 74.

Methods:  This untreated control group design with pretest and posttest study was performed within community settings for two months. Women who received HBM-based Osteoporosis and Fall Prevention Program (n=47) attended a total of 4 sessions of 1-hour long education and counseling once every two weeks. The remaining participants (n=47) in the control group received 1-hour osteoporosis education after posttest.

Results: Results showed statistically significant differences between control and intervention group on the level of osteoporosis and fall related knowledge (t = -13.91, p < 0.001; t = -2.354, p = 0.021), self-efficacy of osteoporotic physical activities (t = 2.736, p = 0.008), and osteoporosis and fall preventive behaviors (t = 4.761, p <0.001; t = 3.879, p < 0.001).

Conclusion:  Participants in the intervention group had significantly higher levels of knowledge, self-efficacy, and preventive behaviors after completing 4 sessions of the program. Therefore, the HBM-based Osteoporosis and Fall Prevention Program seems to have an outstanding effectiveness on osteoporosis and fall prevention among early old aged women. The result is meaningful in terms of the intervention program is basing on a theory. In addition, one-to-one counseling session included in the experimental intervention, but was not in the control intervention, may imply individualized care had been performed and had beneficial impact on increased level of knowledge, self-efficacy, and preventive behaviors. Also, the outcome suggests that the program may have the potential to reduce the cost resulting from long hospital stays by osteoporotic fractures.