Journal of School of Public Health and

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  Background and Aim: Although self-care is known to affect favorably the control and treatment of osteoporosis, the effective factors from the patients’ viewpoint have not been investigated. The aim of this study was to explore factors affecting self-care from the viewpoint of women suffering from osteoporosis.

  Materials and methods: This was a qualitative study conducted with a content analysis approach in 2014, including 15 women consulting the bone mass densitometry centers in Sanandaj, Iran, selected by purposeful sampling. The inclusion criteria were women aged &ge 50 years suffering from osteoporosis diagnosed definitively at least 6 months before, a T-score index > -2.5 (lower back or hip bone), taking drugs upon a physician^’s advice, ability to speak, and willingness to participate in the study. Data were collected through face-to-face and group semi-structured in-depth interviews and analyzed using the content analysis method. The accuracy and rigor of the data were confirmed based on such criteria as credibility, confirmability and transferability.

  Results: Five main categories were extracted including “ background factors of the disease ”, “hope and weakness in confrontation with the disease”, “role of the physician”, “role of the family”, and “administrative centers and organizations”. Based on further analysis of the data, 11 subcategories were emerged including “cultural issues”, “lack of knowledge”, “non-priority of health”, “weakness and fear”,

  “hope for the future” , “positive role of the physician”, “negative role of the physician”, “ active role of the family”, “ passive role of the family”, “ role of the media”, and “information centers”.

  Conclusion: The finding of the study show that the responsibility of women suffering from osteoporosis towards their health is not a single-factor, but rather a multifactorial, phenomenon. Pre-requisites for empowering women to adopt self-care behaviors include increasing their hope to live longer, physician’s attention to the patient’s needs, increasing health promotion programs in the media, and strengthening role of the family (particularly role of men).

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Background and Aim: Physical activity is a low-cost and uncomplicated way for the prevention of osteoporosis. The aim of the present study was to determine the interactive effects of constructs of perceived benefit, barriers, susceptibility and severity on perceived exercise behavior self-efficacy for prevention of osteoporosis based on the Health Belief Model in female-employees of Kermanshah City.

Materials and Methods: This analytic-descriptive study was conducted on 595 female-employees in the governmental and private organizations in 2014. Inclusion criteria included women between the age of 30 years and start of menopause and having no history of osteoporosis. Data were collected using a two-part questionnaire including questions on demographic variables and questions related to the Health Belief Model and analyzed using the SPSS and Lisrel software.      

Results: Analysis of the data showed that perceived severity and perceived barriers had direct and indirect effects on self-efficacy for exercise behavior. Self-efficacy had the highest correlation with perceived benefits (r=0.319). Further analysis of the data revealed a significant inverse correlation between perceived barriers and perceived severity and a significant positive correlation between perceived benefits and perceived severity.

Conclusion: The results of this study show female-employees do not have a high perceived susceptibility or severity to osteoporosis. A high perception of barriers and a low self-efficacy perception indicate the need for implementing appropriate intervention programs and increasing preventive behaviors.

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Background and aim: Health literacy can be one of the most important effective factors in the adoption of preventive behaviors of osteoporosis by raising awareness and understanding the benefits of diagnostic and preventive behaviors. The objective of this study was to determine the health literacy skills effective in predicting adoption of osteoporosis preventive behaviors in high school female students.
Materials and methods: This was a descriptive cross-sectional study including 375 high school girls in Qazvin, Iran, selected by multi-stage sampling. Data were collected using the standard Health Literacy Measure for Adolescents (HELMA) and the Preventive Behavior of Osteoporosis Measurement questionnaires. The data were analyzed using the statistical software SPSS-23, the tests being descriptive statistics, Spearman correlation coefficient and multiple regression analysis.
Results: Two of the eight components of health literacy, namely, understanding and communication, and two, namely usage of health information and calculation, were found to receive the highest and the lowest mean scores, respectively. The total scores of health literacy and the adoption of preventive behaviors of osteoporosis were 70.84±12.58 (out 100) and 22.43±5.60 (out of 36), respectively. Multiple regression analysis showed that the components of health literacy could predict 38.4% of the changes in the adoption of preventive behaviors of osteoporosis (R² = 0.384). The only other predictor of adoption of behavior was the usage of health information (P=0.001، β=0.044). 
Conclusion: Based on the findings of this study, it is recommended to pay special attention, when developing educational programs for the prevention of osteoporosis in adolescents, to health literacy as a whole, especially the usage of health information component. 

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Background and Aim: The Trabecular Bone Score (TBS) is a novel tool for assessing bone microarchitecture and identifying individuals at risk for osteoporotic fractures. This study aimed to evaluate the association between Single Nucleotide Polymorphisms (SNPs) of the SOST gene and TBS in Iranian postmenopausal women.
Materials and Methods: This study included 1/071 postmenopausal women from the Bushehr Elderly Health (BEH) Cohort study. Relationship between Seven independent SNPs in the SOST gene located on chromosome 17q21.31 were investigated with TBS L1–L4. Associations were tested using generalized linear models under additive, dominant, and recessive genetic models. A genetic score was also calculated by summing the weighted number of risk alleles based on the regression coefficients of the SNPs.
Results: After adjustment for age and Body Mass Index (BMI), SNP rs2023794-C showed a statistically significant association with TBS in the additive model (β = 0/ 03, P = 4/7×10⁻⁵, P_FDR = 0/0003) and the dominant model (β = 0/033, P = 2/5×10⁻⁵, P_FDR = 0/0003). Furthermore, higher genetic scores were positively associated with increased TBS values.
Conclusion: Our findings highlight the potential role of SOST gene variants and derived genetic score in predicting bone quality in postmenopausal women. These genes could aid in identifying individuals at higher risk of poor bone quality and in developing personalized osteoporosis prevention strategies.