University of Alabama at Birmingham, Birmingham, AL, 35233, USA.
Rheumatology Unit, University of Verona, Verona, Italy.
Osteoporos Int. 2020 Jul;31(7):1283-1290. doi: 10.1007/s00198-020-05312-4. Epub 2020 Feb 4.
We investigated the factors associated with readiness for initiating osteoporosis treatment in women at high risk of fracture. We found that women in the contemplative stage were more likely to report previously being told having osteoporosis or osteopenia, acknowledge concern about osteoporosis, and disclose prior osteoporosis treatment.
Understanding factors associated with reaching the contemplative stage of readiness to initiate osteoporosis treatment may inform the design of behavioral interventions to improve osteoporosis treatment uptake in women at high risk for fracture.
We measured readiness to initiate osteoporosis treatment using a modified form of the Weinstein Precaution Adoption Process Model (PAPM) among 2684 women at high risk of fracture from the Activating Patients at Risk for OsteoPOroSis (APROPOS) clinical trial. Pre-contemplative participants were those who self-classified in the unaware and unengaged stages of PAPM (stages 1 and 2). Contemplative participants were those in the undecided, decided not to act, or decided to act stages of PAPM (stages 3, 4, and 5). Using multivariable logistic regression, we evaluated participant characteristics associated with levels of readiness to initiate osteoporosis treatment.
Overall, 24% (N = 412) self-classified in the contemplative stage of readiness to initiate osteoporosis treatment. After adjusting for age, race, education, health literacy, and major osteoporotic fracture in the past 12 months, contemplative women were more likely to report previously being told they had osteoporosis or osteopenia (adjusted odds ratio [aOR] (95% CI) 11.8 (7.8-17.9) and 3.8 (2.5-5.6), respectively), acknowledge concern about osteoporosis (aOR 3.5 (2.5-4.9)), and disclose prior osteoporosis treatment (aOR 4.5 (3.3-6.3)) than women who self-classified as pre-contemplative.
For women at high risk for future fractures, ensuring women's recognition of their diagnosis of osteoporosis/osteopenia and addressing their concerns about osteoporosis are critical components to consider when attempting to influence stage of behavior transitions in osteoporosis treatment.
我们研究了与骨折高风险女性开始骨质疏松治疗准备就绪相关的因素。我们发现，处于沉思阶段的女性更有可能报告先前被告知患有骨质疏松症或骨量减少，承认对骨质疏松症的担忧，并透露先前的骨质疏松症治疗情况。
了解与开始骨质疏松治疗准备就绪的沉思阶段相关的因素可能会为改善骨折高风险女性的骨质疏松症治疗吸收率提供信息，从而为行为干预措施的设计提供信息。
我们使用改良的 Weinstein 预防采用过程模型（PAPM）对来自 Activating Patients at Risk for OsteoPOroSis（APROPOS）临床试验的 2684 名骨折高风险女性进行了骨质疏松治疗开始准备就绪的测量。前沉思参与者是那些自我分类为 PAPM 无意识和未参与阶段（阶段 1 和 2）的人。沉思参与者是那些处于犹豫不决、决定不行动或决定行动阶段的人PAPM（阶段 3、4 和 5）。使用多变量逻辑回归，我们评估了与开始骨质疏松治疗准备就绪水平相关的参与者特征。
总体而言，24%（N=412）自我分类为准备开始骨质疏松治疗的沉思阶段。在调整年龄、种族、教育程度、健康素养和过去 12 个月内的主要骨质疏松性骨折后，沉思女性更有可能报告先前被告知患有骨质疏松症或骨量减少（调整后的优势比[OR]（95%CI）分别为 11.8（7.8-17.9）和 3.8（2.5-5.6）），承认对骨质疏松症的担忧（OR 3.5（2.5-4.9）），并透露先前的骨质疏松症治疗（OR 4.5（3.3-6.3））比自我分类为前沉思的女性更有可能。
对于未来骨折风险高的女性，确保女性认识到自己的骨质疏松症/骨量减少诊断并解决她们对骨质疏松症的担忧是尝试影响骨质疏松症治疗行为转变阶段时需要考虑的关键因素。
