G Adami1,2, K G Saag1, A S Mudano1, E J Rahn1, N C Wright1, R C Outman1, S L Greenspan3, A Z LaCroix4,5, J W Nieves6, S L Silverman7, E S Siris8, N B Watts9, M J Miller10,11, S Ladores1, J R Curtis1, M I Danila12. 1. University of Alabama at Birmingham, Birmingham, AL, 35233, USA. 2. Rheumatology Unit, University of Verona, Verona, Italy. 3. University of Pittsburgh, Pittsburgh, PA, 15213, USA. 4. Group Health Cooperative, Seattle, WA, 98112, USA. 5. University of California San Diego, La Jolla, CA, 92093, USA. 6. Helen Hayes Hospital, West Haverstraw, NY, 10993, USA. 7. Cedars-Sinai Medical Center, Los Angeles, CA, 30211, USA. 8. Columbia University Medical Center, New York, NY, 10032, USA. 9. Mercy Health Osteoporosis and Bone Health Services, Cincinnati, OH, 45236, USA. 10. Texas A&M University, College Station, TX, 77843, USA. 11. Kaiser Permanente, Rockville, MD, 20852, USA. 12. University of Alabama at Birmingham, Birmingham, AL, 35233, USA. mdanila@uabmc.edu.
Abstract
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. INTRODUCTION: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
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. INTRODUCTION: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
Entities:
Keywords:
Behavioral changes; Fracture; Osteoporosis; Precaution Adoption Process Model
Authors: Maria I Danila; Ryan C Outman; Elizabeth J Rahn; Amy S Mudano; David T Redden; Peng Li; Jeroan J Allison; Fred A Anderson; Allison Wyman; Susan L Greenspan; Andrea Z LaCroix; Jeri W Nieves; Stuart L Silverman; Ethel S Siris; Nelson B Watts; Michael J Miller; Jeffrey R Curtis; Amy H Warriner; Nicole C Wright; Kenneth G Saag Journal: J Bone Miner Res Date: 2018-02-26 Impact factor: 6.741
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