Division of General Internal Medicine, Department of Internal Medicine, College of Medicine, University of Iowa Carver, Iowa City, IA, USA.
Department of Veterans Affairs, CADRE, Iowa City VA HCS, Iowa City, IA, USA.
Osteoporos Int. 2019 May;30(5):1033-1041. doi: 10.1007/s00198-019-04854-6. Epub 2019 Jan 30.
The Osteoporosis Self Efficacy Scale was determined to equivalently measure calcium and exercise beliefs in both sexes. Despite data illustrating men's and women's similar self-efficacy, gender differences in clinical predictors of self-efficacy imply that efforts to improve care must account for more than self-efficacy.
To understand the extent to which the Osteoporosis Self Efficacy (OSE) Scale is reliable for both men and women. A secondary objective was to evaluate sex differences in OSE.
For this cross-sectional study, we analyzed data collected as part of the Patient Activation after DXA Result Notification (PAADRN) pragmatic trial which enrolled 7749 community-residing adults aged 50 and older reporting for bone densitometry. We used univariable methods, item analysis, exploratory and confirmatory factor analyses, and linear regression to evaluate sex differences in OSE responses and measurement.
In this sample, the confirmatory factor analysis model for OSE both overall and within groups indicated a poor fit. The sex differences in the measurement model, however, were minor and reflected configural invariance (i.e., constructs were measuring the same things in both men and women), confirming that the OSE was measuring the same constructs in men and women. Men overall had higher exercise self-efficacy and women higher calcium self-efficacy. Overall, education, hip fracture, and self-reported health status predicted exercise self-efficacy whereas prior DXA, self-reported osteoporosis, and history of pharmacotherapy use did not. Predictors of calcium self-efficacy differed by gender.
The OSE can be used to measure calcium and exercise self-efficacy in all older adults. However, gender differences in clinical predictors of self-efficacy and the lack of an association of prior DXA with self-efficacy imply that interventions to improve self-efficacy may be insufficient to drive significant improvement in rates of osteoporosis evaluation and treatment.
Patient Activation after DXA Result Notification (PAADRN), NCT01507662, https://clinicaltrials.gov/ct2/show/NCT01507662.
骨质疏松自我效能量表被确定为在两性中均能等效测量钙和运动信念。尽管数据表明男性和女性的自我效能相似，但自我效能的临床预测因素存在性别差异，这意味着改善护理的努力必须不仅仅考虑自我效能。
为了了解骨质疏松自我效能量表（OSE）对男性和女性的可靠性程度。次要目标是评估 OSE 的性别差异。
在这项横断面研究中，我们分析了作为患者 DXA 结果通知后激活（PAADRN）实用试验的一部分收集的数据，该试验招募了 7749 名居住在社区的年龄在 50 岁及以上的成年人，他们进行了骨密度测定。我们使用单变量方法、项目分析、探索性和验证性因素分析以及线性回归来评估 OSE 反应和测量的性别差异。
在该样本中，OSE 的验证性因素分析模型整体和分组内均表现出较差的拟合度。然而，测量模型中的性别差异很小，反映了结构不变性（即，结构在男性和女性中测量相同的事物），这证实了 OSE 在男性和女性中测量相同的结构。总体而言，教育、髋部骨折和自我报告的健康状况预测了运动自我效能，而之前的 DXA、自我报告的骨质疏松症和药物治疗史则没有。钙自我效能的预测因素因性别而异。
OSE 可用于测量所有老年人的钙和运动自我效能。然而，自我效能的临床预测因素存在性别差异，以及之前的 DXA 与自我效能之间缺乏关联，这意味着改善自我效能的干预措施可能不足以显著提高骨质疏松症评估和治疗的比率。
DXA 结果通知后的患者激活（PAADRN），NCT01507662，https://clinicaltrials.gov/ct2/show/NCT01507662。
