Osteoporosis medications used by older African-American women: effects of socioeconomic status and psychosocial factors.

This study examined the effects of socioeconomic status, knowledge and Health Belief Model variables on ever use of hormone therapy and other osteoporosis medications among older African-American women. One-hundred and two African-American women, 60 years old or older, randomly selected from Registers of Voters and a list of participants in educational activities of a university hospital, were interviewed in their homes. Data collected concerned knowledge of osteoporosis, Health Belief Model variables, and cues to action such as history of hysterectomy, personal and family history of cancer, bone mineral density testing, and discussion with a physician about osteoporosis. Socioeconomic status indicators included years of education and household income. The average respondent age was 71.1 years; 47% were current or previous users (ever users) of hormone therapy, and 11% were ever users of other osteoporosis medications. Knowledge of osteoporosis, (odds ratio = 1.4), Hormone therapy benefits, (odds ratio = 1.63), a hysterectomy (odds ratio = 4.35), and a family history of cancer (odds ratio = 4.0) increased the odds of ever using hormone therapy. Perceptions of susceptibility (odds ratio = 3.5) and discussion with a physician about osteoporosis (odds ratio = 6.4) increased odds of ever using other osteoporosis medications. Socioeconomic status mediated the effects of knowledge of osteoporosis on ever using hormone therapy. Efforts to promote bone health to older African-American women should focus primary efforts to increasing perceptions of susceptibility to fracture and persuading physicians to initiate discussions about fracture prevention with African-American patients before a fracture occurs.