Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.
Division of Clinical Immunology and Rheumatology, School of Medicine, University of Alabama at Birmingham, 1665 University Blvd, RPHB 230N, Birmingham, AL, 35294, USA.
J Racial Ethn Health Disparities. 2019 Aug;6(4):707-718. doi: 10.1007/s40615-019-00569-w. Epub 2019 Feb 11.
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.
采用同时进行的混合方法设计，我们调查了骨质疏松症女性的知识、态度、价值观和信念如何解释骨骼健康方面的种族差异。我们招募了年龄≥65 岁、患有骨质疏松症的非裔美国人和白人女性参加焦点小组。我们使用 t 检验比较了种族之间“骨质疏松症与你”知识量表和多维健康控制源量表（内部、强大他人和机会）各领域的得分。我们定性地探讨了在以下领域中态度、价值观和信念的潜在种族差异：（1）骨质疏松症和骨骼健康问题；（2）对骨质疏松症的了解；（3）利用医疗服务治疗骨质疏松症；（4）骨质疏松症预防活动的促进因素；（5）骨质疏松症预防活动的障碍。共有 48 名女性（白人：36 名；非裔美国人：12 名）参加了这项研究。白人女性的平均（SD）得分为 7.8（0.92），而非裔美国女性的平均得分为 6.6（2.6）（p=0.044）。在一般和骨骼健康方面，强大他人领域在非裔美国人中得分均显著更高[一般健康 - 非裔美国人：26.7（5.9）比白人：22.3（3.8）；p=0.01]。定性主题分析显示，在知识、身体活动类型、应对合并症、医生信任、宗教和患者积极性方面存在种族差异。通过使用定量和定性方法，我们的研究发现了骨质疏松症女性在知识、态度和信念方面的种族差异，这可能导致骨骼健康方面的种族差异，表明需要加强对非裔美国女性的骨质疏松症教育和意识。
