Jeihooni Ali Khani, Hidarnia Alireza, Kaveh Mohammad Hossein, Hajizadeh Ebrahim, Askari Alireza
Department of Public Health, Fasa University of Medical Sciences, Fasa, Iran.
Department of Health Education and Health Promotion, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
Int J Prev Med. 2015 Nov 24;6:115. doi: 10.4103/2008-7802.170429. eCollection 2015.
Osteoporosis is the most common metabolic bone disease. The study's objective is to investigate the effect of an educational program based on Health Belief Model (HBM) on preventing osteoporosis in women.
In this quasi-experimental study, 120 patients (60 experimental and 60 control) who were registered under the health centers in Fasa City, Fars Province, Iran, were selected in 2014. A questionnaire consisting of demographic information, HBM constructs was used to measure nutrition and walking performance for the prevention of osteoporosis before, immediately after intervention, and 6 months later. Bone mineral density (BMD) was recorded at the lumbar spine and femur before and 6 months after intervention.
The mean age of women participated in the study was 41.75 ± 5.4 years for the experimental group, and 41.77 ± 5.43 years for the control group. The mean body mass index was 22.44 ± 3.30 for the experimental group and 22.27 ± 3.05 for the control group. The average number of women deliveries for the experimental group was 2.57 ± 1.47 and 2.50 ± 1.19 for the control group. There is no significant difference between the two groups in education level (P = 0.771), marital status (P = 0.880), occupation (P = 0.673), breastfeeding (P = 0.769), smoking (P = 0.315), history of osteoporosis in the family (P = 0.378), history of special diseases (P = 0.769), and records of bone densitometry (P = 0.543). Immediately and 6 months after intervention, the experimental group showed a significant increase in the knowledge, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, self-efficacy, internal cues to action, nutrition, and walking performance compared to the control group. Six months after intervention, the value of lumbar spine BMD T-score in the experimental group increased to 0.127, while in the control group it reduced to -0.043. The value of the hip BMD T-score in the intervention group increased to 0.125, but it decreased to -0.028 in the control group.
This study showed the effectiveness of knowledge, walking, and diet on bone mass by HBM. Hence, these models can act as a framework for designing and implementing educational interventions for the osteoporosis prevention.
骨质疏松症是最常见的代谢性骨病。本研究的目的是调查基于健康信念模型（HBM）的教育项目对预防女性骨质疏松症的效果。
在这项准实验研究中，2014年从伊朗法尔斯省法萨市健康中心登记的患者中选取了120名患者（60名实验组和60名对照组）。使用一份包含人口统计学信息、HBM结构的问卷，在干预前、干预后即刻以及6个月后测量预防骨质疏松症的营养和步行表现。在干预前和干预后6个月记录腰椎和股骨的骨密度（BMD）。
参与研究的女性，实验组平均年龄为41.75±5.4岁，对照组为41.77±5.43岁。实验组平均体重指数为22.44±3.30，对照组为22.27±3.05。实验组女性平均分娩次数为2.57±1.47，对照组为2.50±1.19。两组在教育水平（P = 0.771）、婚姻状况（P = 0.880）、职业（P = 0.673）、母乳喂养情况（P = 0.769）、吸烟情况（P = 0.315）、家族骨质疏松病史（P = 0.378）、特殊疾病史（P = 0.769）以及骨密度测量记录（P = 0.543）方面均无显著差异。与对照组相比，干预后即刻及6个月时，实验组在知识、感知易感性、感知严重性、感知益处、感知障碍、自我效能、行动的内部线索、营养和步行表现方面均有显著提高。干预6个月后，实验组腰椎BMD T值升至0.127，而对照组降至 -0.043。干预组髋部BMD T值升至0.125，但对照组降至 -0.028。
本研究表明，通过HBM，知识、步行和饮食对骨量有显著效果。因此，这些模型可作为设计和实施预防骨质疏松症教育干预措施的框架。
