Sex differences in osteoporosis self-efficacy among community-residing older adults presenting for DXA

S L Solimeo; V-T T Nguyen; S W Edmonds; Y Lou; D W Roblin; K G Saag; P Cram; F D Wolinsky

doi:10.1007/s00198-019-04854-6

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Sex differences in osteoporosis self-efficacy among community-residing older adults presenting for DXA

Journal article

Peer reviewed

Sex differences in osteoporosis self-efficacy among community-residing older adults presenting for DXA

S L Solimeo, V-T T Nguyen, S W Edmonds, Y Lou, D W Roblin, K G Saag, P Cram and F D Wolinsky

Osteoporosis international, Vol.30(5), pp.1033-1041

05/2019

DOI: 10.1007/s00198-019-04854-6

PMCID: PMC7720864

PMID: 30701343

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Abstract

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.

Self Efficacy

Cross-Sectional Studies

Osteoporosis - therapy

Humans

Middle Aged

Osteoporosis - diagnosis

Self Report

Independent Living

Male

Psychometrics

Sex Characteristics

Health Knowledge, Attitudes, Practice

Absorptiometry, Photon

Health Behavior

Calcium, Dietary - administration & dosage

Exercise Therapy - psychology

Female

Aged

Patient Compliance - psychology

Health Status

Osteoporosis - psychology

Patient Education as Topic - methods

Details

Title: Subtitle: Sex differences in osteoporosis self-efficacy among community-residing older adults presenting for DXA
Creators: S L Solimeo - Department of Veterans Affairs, CADRE, Iowa City VA HCS, Iowa City, IA, USA. Samantha-solimeo@uiowa.edu
V-T T Nguyen - Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USA
S W Edmonds - College of Nursing, University of Iowa, Iowa City, IA, USA
Y Lou - Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, IA, USA
D W Roblin - Kaiser Permanente, Rockville, MD, USA
K G Saag - Division of Clinical Immunology and Rheumatology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
P Cram - Division of General Internal Medicine and Geriatrics, Mt. Sinai/UHN Hospitals, Toronto, Canada
F D Wolinsky - Department of Health Management and Policy, College of Public Health, University of Iowa, Iowa City, IA, USA
Resource Type: Journal article
Publication Details: Osteoporosis international, Vol.30(5), pp.1033-1041
DOI: 10.1007/s00198-019-04854-6
PMID: 30701343
PMCID: PMC7720864
NLM abbreviation: Osteoporos Int
ISSN: 0937-941X
eISSN: 1433-2965
Grant note: IK2 HX001542 / HSRD VA CIN 13-412 / VA HSR&D, Center for Comprehensive Access & Delivery Research and Evaluation (CADRE), Department of Veterans Affairs, Iowa City VA Health Care System, Iowa City, IA CDA 13-272 / VA HSR&D Career Development Award R01 AG033035 / NIA NIH HHS
Language: English
Date published: 05/2019
Academic Unit: Health Management and Policy; Nursing; General Internal Medicine; Internal Medicine
Record Identifier: 9984094358502771

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