Relationship of knowledge about osteoporosis with education level and life habits

Findings of preoperative patient risk factors to predict dislocation following total hip arthroplasty

Background

Previous studies have identified some risk factors of dislocation after total hip arthroplasty (THA). However, there are many vital preoperative patient risk factors remaining unknown. This study aimed to investigate comprehensively patient risk factors to reduce the dislocation rate after THA.

Methods

We retrospectively reviewed patients who underwent primary THA in our department between January 2016 to December 2020. All readmissions related to postoperative dislocation were recorded, and each patient who dislocated was matched with three patients who did not dislocate according to date of operation, operative time and follow-up time. Patient risk factors were initially analyzed by univariate analyses, and independent risk factors for dislocation were identified by multivariate logistic regression.

Results

A total of 5,133 patients were reviewed and 76 patients were readmitted with postoperative dislocations in follow-up time (1.5%). Age (odds ratio [OR], 1.027; 95% confidence interval [CI], 1.000-1.055; P = 0.049), rheumatoid arthritis (OR, 7.976; 95% CI, 1.419-44.827; P = 0.018), low serum calcium level (OR, 0.009; 95% CI, 0.000-0.211; P = 0.003) and poor education degree (OR, 0.847; 95% CI, 0.770-0.932; P = 0.001) were determined as independent predictors associated with dislocation after THA.

Conclusion

Patients with older age, rheumatoid arthritis, low serum calcium level, and poor education degree require targeted optimization of preoperative planning and should be performed by appropriate surgical techniques and hip prostheses to prevent dislocation after THA and revision surgeries.

Distribution and diagnostic modeling of osteoporosis and comorbidities across demographic factors: A cross-sectional study of 2224 female patients

OBJECTIVE

This study investigates the distribution of osteoporosis (OP) and its associated comorbidities across different demographic factors. Furthermore, this study seeks to develop a statistically-based diagnostic model leveraging demographic and health indicators to provide personalized risk assessments for OP.

METHODS

A retrospective analysis was conducted on the demographic data, health profiles, and bone density measurements of 2224 female patients. Key variables associated with OP were identified using chi-square tests. Feature selection was refined through Lasso regression and recursive feature elimination (RFE), which guided the development of a logistic regression-based dynamic nomogram. This model was subsequently implemented on the Shiny platform for personalized online OP risk assessments.

RESULTS

Among 2224 female patients, 801 (36.0 %) were diagnosed with OP. Women aged 70 and older exhibited a significantly higher prevalence of OP compared to younger age groups (OR = 5.83, 95 % CI: 1.74-19.61, P = 0.004), and this remained significant in the multivariable analysis (OR = 5.18, 95 % CI: 1.19-22.52, P = 0.028). Later age at menarche was associated with increased OP risk (OR = 1.31, 95 % CI: 1.09-1.57, P = 0.004), persisting in multivariable analysis (OR = 1.25, 95 % CI: 1.03-1.52, P = 0.023). In rheumatoid arthritis (RA) patients, higher education reduced OP risk, with secondary education (OR = 0.09, P = 0.024) and college education (OR = 0.04, P = 0.009) showing protective effects. Diabetic patients who were unmarried or had non-traditional marital statuses showed increased OP risk (univariate OR = 2.73, P = 0.006; multivariate OR = 2.34, P = 0.029). Among nonalcoholic fatty liver disease (NAFLD) patients, age at menopause was significantly linked to OP risk (univariate OR = 1.04, P = 0.012). The prediction model showed strong performance (AUC = 0.720), and the dynamic nomogram on the Shiny platform provided effective personalized OP risk assessments.

CONCLUSION

Age and age at menarche are significant risk factors for OP, with later menarche increasing the risk. In RA patients, higher education levels were associated with a lower risk of OP. In contrast, unmarried or non-traditional marital statuses increased OP risk among diabetic patients. Additionally, age at menopause was found to be a significant factor for OP risk in NAFLD patients. The prediction model developed in this study, with an AUC of 0.720, provides a reliable method for personalized OP risk assessment through a dynamic nomogram. These findings highlight the crucial role of demographic factors in predicting OP risk and underscore the importance of personalized treatment strategies for effective OP prevention and management.

Assessing osteoporosis awareness and knowledge levels of Turkish multiple sclerosis patients: an observational study

This study assessed osteoporosis knowledge and awareness among multiple sclerosis patients. The findings reveal a concerning lack of knowledge and awareness regarding osteoporosis, emphasizing the necessity for educational interventions to enhance early detection and mitigate complications within this particular patient group.

AIM

To assess the knowledge and awareness of osteoporosis in Turkish multiple sclerosis (MS) patients.

MATERIAL-METHODS

Three hundred twenty-five patients were asked to fill out the osteoporosis awareness scale (OAS), which has a scoring range of 31-124, and the revised osteoporosis knowledge test (R-OKT), which has a score range of 0-32. Fall risk assessment for patients was conducted using the timed up-and-go test (high risk: > 30, moderate risk: 29-20, low risk: 14-19, and no risk: < 13 s).

RESULTS

An average score of 59.42 ± 19.63(31%) on the OAS and 14.99 ± 5.39 (47%) on the R-OKT was detected. No difference was found in R-OKT scores between genders, education levels, and patients with different fall risks and between genders and education levels in OAS scores. Patients with low, medium, and high fall risks exhibited higher OAS scores compared to those without any fall risk (p = 0.006, p < 0.001, and p < 0.001, respectively). No correlation was found between gender and education level with OAS and R-OKT scores and between the R-OKT scores and the risk of falls. There was a weak correlation between the OAS scores and an increased risk of falls (r = 0.269, p < 0.001). No differences between the age groups regarding OAS and R-OKT scores were observed.

CONCLUSIONS

Turkish MS patients have inadequate knowledge and low awareness of OP compared to the healthy population. Urgent action is warranted to educate and support individuals with MS, implementing targeted interventions and awareness campaigns to improve early detection and prevent osteoporosis-related complications.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT05760651.

Knowledge and Awareness of Osteoporosis and Its Risk Factors Among the Adult Population in Jeddah, Saudi Arabia: An Analytical Cross-Sectional Study

BACKGROUND

Osteoporosis is a medical condition that affects the bones, causing them to become weak and fragile. People with osteoporosis are at a higher risk for fractures, resulting in an increase in morbidity and mortality rates. Despite its high prevalence worldwide, osteoporosis remains underdiagnosed and undertreated, leading to significant public health concerns, especially in Saudi Arabia.

MATERIAL AND METHODS

An analytical cross-sectional study was conducted using an online questionnaire to assess the level of awareness of osteoporosis and its risk factors among the adult population in Jeddah, Saudi Arabia. The questionnaire was distributed to a diverse, representative sample of 232 adults in Jeddah, covering demographic data, knowledge and awareness of osteoporosis and its risk factors, and lifestyle practices related to prevention and management. Data were analyzed using IBM Corp. Released 2013. IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY: IBM Corp., employing descriptive analysis, cross-tabulation, and chi-square tests to evaluate knowledge levels and associated factors.

RESULTS

A total of 232 eligible adults participated, with a mean age of 35.6 ± 8.7 years. Most participants, 228 (98.3%), had heard of osteoporosis, and 137 (59.1%) had good overall knowledge of the disease. Key risk factors identified included calcium deficiency (210, 90.5%), increasing age (171, 73.7%), and family history (136, 58.6%). Although most participants accurately identified common risk factors, only 10.8% of participants consistently practiced a healthy and active lifestyle, highlighting the gap between awareness and preventive behaviors. Our study showed that gender (p-value = 0.049), educational level (p-value = 0.044), and whether the participant was diagnosed with or knew someone diagnosed with osteoporosis (p-value = 0.045) were statistically significant factors associated with the overall level of knowledge of osteoporosis in the participants.

CONCLUSIONS

This study emphasized the need for targeted interventions to improve knowledge and promote healthier lifestyle habits among adults in Jeddah to reduce the burden of osteoporosis. Future efforts should focus on bridging the gap between awareness and preventive actions, emphasizing the importance of healthy lifestyle habits and knowledge of osteoporosis risk factors.

Prevalence of osteoporosis and associated factors among people aged 50 years and older in the Madhesh province of Nepal: a community-based cross-sectional study

BACKGROUND

The high prevalence of osteoporosis has increased the economic burden on the health system globally. The burden of osteoporosis and its associated factors have not been adequately assessed in community settings in the Nepalese context thus far. Therefore, this study aimed to assess the prevalence of osteoporosis and its associated factors, lifestyle behaviors, and dietary calcium intake.

METHODS

A community-based cross-sectional study was conducted among 395 people aged 50 years and older in the Madhesh Province of Nepal between July 2022 and August 2023. The Osteoporosis Self-assessment Tools for Asians (OSTA) index was used to measure osteoporosis. A structured questionnaire was used to collect sociodemographic information, anthropometric data, lifestyle behavior, daily dietary calcium intake, and frequency of calcium-rich food consumption. A food frequency questionnaire and 24-hour recall methods were used to assess dietary intake. The chi-square test, binary logistic regression and Mann‒Whitney U test were applied to measure the association between predictors and the outcome of interest.

RESULTS

The prevalence of no risk, moderate risk and high risk of osteoporosis were 38.7%, 39%, and 22.3% respectively. The risk of osteoporosis was higher in females (aOR = 5.18, CI: 2.10-12.75, p < 0.001) and increased risk with advancing age (aOR = 32.49, CI: 14.02-75.28, p < 0.001). Similarly, underweight was associated with increased odds of having osteoporosis (aOR = 13.42, CI = 4.58-39.30, p < 0.001). The incidence of osteoporosis was strongly associated with daily calcium intake of 225 mg (100, 386).

CONCLUSION

This study revealed a high prevalence of osteoporosis among people aged 50 years and older due to the combined effect of being underweight and having inadequate calcium intake. Nutritional counselling services encourage people to consume sufficient calcium-rich food and adopt an appropriate lifestyle behaviours to maintain healthy body weight so that osteoporosis and osteoporotic fractures could be prevented. Further research can explore the impact of socioeconomic status and medical comorbidities on a large scale.

Assessment of osteoporosis knowledge and its determinants among tuberculosis patients in tertiary care hospital Malaysia: A prospective study

Objective

Osteoporosis self-care knowledge is essential to encourage the patient's contribution towards controlling the disease. Osteoporosis incidence with various infectious diseases prompts us to conduct a study on osteoporosis knowledge among Tuberculosis (TB) patients. This study aimed to assess osteoporosis-related knowledge and its influencing factors among TB patients.

Methods

A prospective cross-sectional study was conducted in the TB clinic of Hospital Pulau Pinang, Malaysia, and an osteoporosis knowledge test (OKT), a structured questionnaire, was used to collect data. TB patients aged 18 years and above with compromised bone health were included in the present study. Overall knowledge scores were dichotomized, calculating the mean score, descriptive statistics, and multivariate regression analysis was used to determine the influence of risk factors on knowledge scores.

Results

Of 337 patients, 129(38.28 %) had good osteoporosis knowledge and 208(61.72 %) had poor knowledge. Among them, 231(68.54 %) were males, and 106(31.45 %) were females, with a mean age of 46.5 ± 17.1 years. The mean ± SD of OKT total score was 10.5 ± 2.0. The mean ± SD of the exercise knowledge score was 5.3 ± 3.4, while the nutrition knowledge score was 5.0 ± 3.2. Male gender (OR 3.86, 95 % CI 1.98-7.53), low-income level (OR 1.92, 95 % CI 1.12-3.30), rural residents (OR 2.49, 95 % CI 1.46-4.27) and participants with no formal education (OR 4.34, 95 % CI 1.11-16.84) or ≤12 years of education (OR 3.63, 95 % CI 1.52-8.65) were significantly responsible for poor OKT score.

Conclusion

The results indicated that most TB patients had a poor perception of osteoporosis. More extensive strategies should be developed to enhance the campaign of awareness programs among TB patients to improve preventive measures of osteoporosis, such as calcium intake and exercise.

Health Impact of Drinking Water Quality on the Occurrence of Osteoporosis in Gaza Strip, Palestine

Background

Improving water supply quality could be essential for disease prevention strategy that promotes human health. The study aims to investigate the relationship between drinking water quality and the occurrence of osteoporosis in Gaza Strip.

Methods

A case-control study design was used, and a multistage sampling method was employed at the main orthopedic clinic. Participants included 200 individuals diagnosed with osteoporosis and 200 without osteoporosis. All subjects underwent a DEXA scan, and drinking water samples for chemical analysis were done. A structured face-to-face interview was conducted Statistical analysis was performed using SPSS 26, and both descriptive and inferential statistics (chi-square and binary logistic regression) were used.

Results

Factors such as the source of drinking and cooking water, lifestyle, and socioeconomic status were found important in the occurrence of osteoporosis. The source of drinking, cooking water, lifestyle, and socioeconomic played a significant impact in the development of osteoporosis. Bivariate analysis revealed that a number of factors, including female gender, low physical activity, older age (41-50), inadequate education, drinking and cooking water source, and older age (41-50), had a statistically significant association with osteoporosis. With the exception of Mg (>PH =.105, Ca =.102, Mg =.046), the chemical water quality parameter had an impact on the occurrence of osteoporosis but did not achieve a significant difference. Osteoporosis was less likely to occur in people who were obese. Age, obesity, and the lack of magnesium in drinking water were independent predictors of osteoporosis.

Conclusions

The study has identified the need for preventive measures to improve drinking water quality to reduce the incidence of various health conditions, including osteoporosis.

The effect of educational intervention based on the theory of planned behavior aimed at mothers on osteoporosis prevention behaviors in lower secondary school female students

BACKGROUND

Osteoporosis is mainly characterized by a low bone mineral density and a sharp architectural and biomechanical deterioration in bone tissue required to maintain bone homeostasis. The theory of planned behavior (TPB) can be considered as one of the leading theories when designing an evidence-based intervention. This study was carried out based on the TPB to determine the effect of an educational intervention aimed at mothers on the prevention of osteoporosis in female students.

MATERIALS AND METHODS

A total of seventy mothers of lower secondary school students in Tehran, Iran, participated in this experimental study which was conducted in 2019-2020. The participants were randomly assigned to two groups, namely experimental and control groups. Based on the TPB, a demographic and a researcher-made questionnaire consisting of five sections were used in order to collect data. The validity and reliability of the questionnaires were confirmed before data collection. Four 45-60 min training programs were delivered to the subjects using the TPB. Data were collected before, immediately after, and 1 month following the training program. Finally, IBM SPSS Statistics 21 was used for statistical analysis.

RESULTS

No significant difference was observed in terms of attitude, subjective norms, perceived behavioral control, behavioral intention, and osteoporosis prevention-related behavior between the experimental and control groups before proceeding with the intervention (P > 0.05). However, the mean scores of attitude, subjective norms, perceived behavioral control, behavioral intention, and behavior were significantly higher in the experimental group compared to those of the control group following the educational intervention (P < 0.05).

CONCLUSION

It can be concluded that such interventions based on the TPB can, in fact, produce a significant effect on osteoporosis prevention-related behaviors. Thus, it can serve as a useful model for planning educational interventions.

Osteoporosis awareness among patients in Singapore (OASIS)-a community hospital perspective

This study examines factors associated with osteoporosis awareness and knowledge using Osteoporosis Prevention and Awareness Tool (OPAAT). Of 410 patients, majority of patients had a OPAAT score < 24 (n = 362, 88.3%). Lower education level (odds ratio (OR) (primary education): 3.63; OR (no formal education): 111.5; p < 0.001) and diabetic patients (OR: 1.67; p = 0.003) were associated with lower OPAAT scores.

INTRODUCTION

Lack of osteoporosis awareness forms a critical barrier to osteoporosis care and has been linked with increased institutionalization, healthcare expenditures, and decreased quality of life. This study aims to identify factors associated with osteoporosis awareness and knowledge among female Singaporeans.

METHODOLOGY

A cross-sectional study was conducted among adult female patients (aged 40 to 90 years old) who were admitted into Outram Community Hospital from April to October 2020. Osteoporosis awareness and knowledge were assessed using interviewer-administered Osteoporosis Prevention and Awareness Tool (OPAAT). High knowledge was defined as a OPAAT score ≥ 24. Multivariate logistical regression analyses were used to identify predictors of low OPAAT scores.

RESULTS

Of 410 patients recruited, their mean age was 71.9 ± 9.5 years old and majority of patients had a OPAAT score < 24 (n = 362, 88.3%). Patients with lower OPAAT scores tended to be older (72.5 ± 9.2 vs 67.5 ± 10.1, p < 0.001), attained lower education level (p < 0.001), and were more likely to live in public housing (92.5% vs 81.5%, p = 0.009). The prevalence of diabetes mellitus was higher in patients with low OPAAT scores (39.2% vs 18.8%, p = 0.006). After adjustment for covariates, lower education level (odds ratio (OR) (primary education): 3.63; OR (no formal education): 11.5; p < 0.05) and patients with diabetes mellitus (OR: 1.67; p = 0.03) were associated with lower OPAAT knowledge scores.

CONCLUSION

Elderly female patients in community hospital have inadequate osteoporosis awareness despite being at risk of fractures. There is a need to address the knowledge gap in osteoporosis, especially among diabetic patients or patients with lower education.

Osteoporosis knowledge and awareness among university students in Saudi Arabia

Awareness and knowledge about any disease is the first step to prevent and treat it, so this study evaluates osteoporosis awareness and knowledge in university students. Our results showed a high awareness and good knowledge of osteoporosis. Females were better informed than males. Knowledge increased with increasing education level.

PURPOSE

Osteoporosis is a worldwide health problem, including Saudi Arabia where vitamin D deficiency is common. Prevention of osteoporosis must begin by increasing awareness of the disease from a young age. This study aimed to assess awareness and knowledge of osteoporosis among young adults (18-30 years) attending Saudi universities, exploring the relationship between education and gender and the sources of information in this age group.

METHODS

A cross-sectional survey was conducted in 337 students (176 females; 161 males) randomly selected from four Saudi universities during January-December 2017. Education level ranged from preparatory year to undergraduate and postgraduate levels. A self-reported questionnaire was designed to assess awareness and knowledge of osteoporosis across several domains, including risk factors for the disease, prevalence, symptoms, prevention, and treatment.

RESULTS

Overall, 92% of students had some awareness of osteoporosis through a variety of sources, predominantly via friends. Just over half of all students had a good or high knowledge level overall (53.4 ± 16.6%). Knowledge score correlated with education (r2 = 0.28) and gender (r2 = 0.27); p < 0.0001. Females were better informed than males (57.7 ± 15.4% vs 48.8 ± 16.8%; p < 0.0001). Knowledge increased with increasing education level (preparatory year (47.8 ± 15.3%), undergraduate (53.5 ± 16.5%), and postgraduate (61.8 ± 15.8%); all p < 0.0001).

CONCLUSION

Knowledge of osteoporosis was good among university students in Saudi Arabia, higher in females and with increasing years of education. Overall, students were more knowledgeable about risk factors compared to other aspects such as symptoms, prevention, or treatment of osteoporosis.

Osteoporosis Knowledge and Health Beliefs Among Men in Midlife Years

OBJECTIVE

To examine the role of socioeconomic variables on middle-aged adult men's knowledge and health beliefs about osteoporosis.

METHODS

An anonymous survey used validated scales to assess osteoporosis knowledge and health beliefs in a sample of 262 men aged 36-55 years. Descriptive and group-differences statistics (MANOVA and ANOVA) were used.

RESULTS

Total osteoporosis knowledge was low (mean, 11.1 of 22) and mean scores on perceived susceptibility and seriousness health belief domains were also low: 13.2 and 17.2, respectively out of 30. Multivariate ANOVA revealed that perceived seriousness, barriers to calcium intake, and health motivation varied significantly with level of formal education attained (P < .05). There was no significant difference with income.

CONCLUSIONS AND IMPLICATIONS

Results of this convenience sample of predominantly white men found that level of osteoporosis knowledge and perceived susceptibility were low. Given the increased prevalence of osteoporosis-related fracture in men, methods to increase knowledge and awareness are needed.

A model of health education and management for osteoporosis prevention

Osteoporosis, a chronic disease with no therapeutic cure, affects a growing number of people as the aging population in China rapidly increases. Therefore, developing an evidence-based model of health education and management for osteoporosis prevention is required. In the present study, an osteoporosis club was established, which is a novel model of health education and management for osteoporosis prevention. A unified management of membership was used based on a digitized database. A total of 436 patients with osteoporosis were randomly assigned to the osteoporosis club group or the self-management control group. For the osteoporosis club group, multiple activities of health education were performed, including monthly systematic health education lectures, exercise programs and communication parties once a year. For the control group, the participants took charge of their own musculoskeletal health. All data of the participants were collected and evaluated prior to and following intervention. In the pre-intervention assessment, no significant difference was identified in the health education between the two groups. Through the four-year intervention, the osteoporosis knowledge, health beliefs, living behavior, medication compliance, quality of life and bone mineral density of the osteoporosis club group were improved significantly compared with the control group (P<0.001), while the pain degree of the osteoporosis club group was relieved significantly more compared with the control group (P<0.001). The results in the present study suggest that setting up an osteoporosis club is an evidence-based model of health education and management for osteoporosis prevention in China.

A cross-sectional study for estimation of associations between education level and osteoporosis in a Chinese men sample

BACKGROUND

The main aim of this study was to evaluate the association between education level and osteoporosis (OP) in general Chinese Men.

METHODS

We conducted a large-scale, community-based, cross-sectional study to investigate the association by using self-report questionnaire to assess education levels. The data of 1092 men were available for analysis in this study. Multiple regression models controlling for confounding factors to include education level were performed to explore the relationship between education level and OP.

RESULTS

Positive correlations between education level and T-score of quantitative bone ultrasound (QUS-T score) were reported (β = 0.108, P value < 0.001). Multiple regression analysis indicated that the education level was independently and significantly associated with OP (P < 0.1 for all models). The men with lower education level had a higher prevalence of OP.

CONCLUSION

The education level was independently and significantly associated with OP. The prevalence of OP was more frequent in Chinese men with lower education level.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT02451397 ; date of registration: 05/28/2015).

A cross-sectional study to estimate associations between education level and osteoporosis in a Chinese postmenopausal women sample

BACKGROUND

Our research aims to investigate the associations between education level and osteoporosis (OP) in Chinese postmenopausal women.

METHODS

A large-scale, community-based, cross-sectional study was conducted to examine the associations between education level and OP. A self-reported questionnaire was used to access the demographical information and medical history of the participants. A total of 1905 postmenopausal women were available for data analysis in this study. Multiple regression models controlling for confounding factors to include education level were performed to investigate the relationship with OP.

RESULTS

The prevalence of OP was 28.29% in our study sample. Multivariate linear regression analyses adjusted for relevant potential confounding factors detected significant associations between education level and T-score (β = 0.025, P-value = 0.095, 95% CI: -0.004-0.055 for model 1; and β = 0.092, P-value = 0.032, 95% CI: 0.008-0.175 for model 2). Multivariate logistic regression analyses detected significant associations between education level and OP in model 1 (P-value = 0.070 for model 1, Table 5), while no significant associations was reported in model 2 (P value = 0.131). In participants with high education levels, the OR for OP was 0.914 (95% CI: 0.830-1.007).

CONCLUSION

The findings indicated that education level was independently and significantly associated with OP. The prevalence of OP was more frequent in Chinese postmenopausal women with low educational status.

The Development and Validation of the Osteoporosis Prevention and Awareness Tool (OPAAT) in Malaysia

OBJECTIVES

To develop and validate Osteoporosis Prevention and Awareness Tool (OPAAT) in Malaysia.

METHODS

The OPAAT was modified from the Malaysian Osteoporosis Knowledge Tool and developed from an exploratory study on patients. Face and content validity was established by an expert panel. The OPAAT consists of 30 items, categorized into three domains. A higher score indicates higher knowledge level. English speaking non-osteoporotic postmenopausal women ≥ 50 years of age and pharmacists were included in the study.

RESULTS

A total of 203 patients and 31 pharmacists were recruited. Factor analysis extracted three domains. Flesch reading ease was 59.2. The mean ± SD accuracy rate was 0.60 ± 0.22 (range: 0.26-0.94). The Cronbach's α for each domain ranged from 0.286-0.748. All items were highly correlated (Spearman's rho: 0.761-0.990, p < 0.05), with no significant change in the overall test-retest scores, indicating that OPAAT has achieved stable reliability. Pharmacists had higher knowledge score than patients (80.9 ± 8.7 vs 63.6 ± 17.4, p < 0.001), indicating that the OPAAT was able to discriminate between the knowledge levels of pharmacists and patients.

CONCLUSION

The OPAAT was found to be a valid and reliable instrument for assessing patient's knowledge about osteoporosis and its prevention in Malaysia. The OPAAT can be used to identify individuals in need of osteoporosis educational intervention.