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J Racial Ethn Health Disparities. 2019 Aug;6(4):707-718. doi: 10.1007/s40615-019-00569-w. Epub 2019 Feb 11.

Race Plays a Role in the Knowledge, Attitudes, and Beliefs of Women with Osteoporosis.

Author information

1
Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA. ncwright@uab.edu.
2
Division of Clinical Immunology and Rheumatology, School of Medicine, University of Alabama at Birmingham, 1665 University Blvd, RPHB 230N, Birmingham, AL, 35294, USA. ncwright@uab.edu.
3
Division of Clinical Immunology and Rheumatology, School of Medicine, University of Alabama at Birmingham, 1665 University Blvd, RPHB 230N, Birmingham, AL, 35294, USA.
4
Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.
5
School of Medicine, Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA.
6
Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.
7
Department of Health Services Administration, School of Health Profession, University of Alabama at Birmingham, Birmingham, AL, USA.

Abstract

Using a concurrent mixed methods design, we investigated how knowledge, attitudes, values, and beliefs among women with osteoporosis can explain racial disparities in bone health. We recruited African American and White women ≥ 65 years of age with osteoporosis to participate in focus groups. We quantitatively compared scores of the "Osteoporosis & You" knowledge scale and each domain (internal, powerful others, and chance) of the Multidimensional Health Locus of Control scale by race using t tests. We qualitatively explored potential racial differences in attitudes, values, and beliefs in the domains: (1) osteoporosis and bone health concerns, (2) knowledge about osteoporosis, (3) utilization of medical services for osteoporosis, (4) facilitators of osteoporosis prevention activities, and (5) barriers to osteoporosis prevention activities. A total of 48 women (White: 36; African American: 12) enrolled in the study. White women had a mean (SD) of 7.8 (0.92), whereas African American women score a 6.6 (2.6) (p = 0.044) out of 10 on the Osteoporosis & You Scale. The powerful others domain was significantly higher among African American for both general and bone health [General Health - African American: 26.7 (5.9) vs. White: 22.3 (3.8); p = 0.01]. Qualitative thematic analysis revealed differences by race in knowledge, types of physical activity, coping with comorbidities, physician trust, religion, and patient activation. Using both quantitative and qualitative methods, our study identified racial differences in knowledge, attitudes, and beliefs in women with osteoporosis that could result in racial disparities in bone health, indicating the need to improve education and awareness about osteoporosis in African American women.

KEYWORDS:

Disparities; Epidemiology; Mixed-methods; Osteoporosis

PMID:
30747331
PMCID:
PMC6660986
[Available on 2020-08-01]
DOI:
10.1007/s40615-019-00569-w

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