Osteoporosis is a significant public health problem characterized by low bone mass and deterioration in the microarchitecture of bone tissue, leading to an increased risk of fractures. Risk factors such as advanced age, female gender, inadequate calcium and vitamin D intake, physical inactivity, smoking, and alcohol use play a critical role in its development. As in many countries, the prevalence of osteoporosis is increasing in Turkey, accelerated by an aging population and lifestyle changes. However, it is reported that the level of awareness and knowledge about osteoporosis in the community is often insufficient.
This study is a randomized controlled experimental trial with a two-group pretest-posttest design, conducted between February 1 and June 1, 2026, among women aged 45 and older who have not been diagnosed with osteoporosis but carry at least one osteoporosis risk factor, attending the Physical Therapy and Rehabilitation outpatient clinic at Bartın State Hospital. From the study population, participants who meet the inclusion criteria and volunteer will be randomly assigned to intervention and control groups. The sample size is determined as 74, calculated with a 95% confidence level and a 5% margin of error. While the intervention group receives a structured education program based on the Health Belief Model, the control group will receive no education.
The dependent variables of the study are osteoporosis awareness and health beliefs. These variables will be measured before and after the intervention using the Osteoporosis Awareness Scale and the Osteoporosis Health Belief Scale, which includes subdimensions of perceived susceptibility, seriousness, benefits, and barriers. The effectiveness of the education program will be evaluated through inter-group and intra-group comparisons.
Being a woman aged 45 and over
Not having been diagnosed with osteoporosis
Having at least one of the risk factors for osteoporosis development as stated in the literature (being in menopause, family history of osteoporosis, low level of physical activity, insufficient calcium/vitamin D intake, low body mass index, etc.)
Having applied to the Physical Therapy and Rehabilitation Outpatient Clinic of Bartın State Hospital
Having a previous diagnosis of osteoporosis
Having a serious endocrine or rheumatological disease affecting bone metabolism
Having a history of long-term (≥ 3 months) systemic corticosteroid use
Having participated in a structured education program related to osteoporosis within the last 6 months
Parallel
Osteoporosis Education Based on the Health Belief Model
BehavioralIntervention Description This study evaluates a hybrid educational program based on the Health Belief Model (HBM), focusing on perceived susceptibility, severity, benefits, and barriers. 1. Baseline Assessment: Participants in both groups complete questionnaires on osteoporosis awareness and health beliefs. 2. Educational Intervention (Intervention Group): Initial Session: A 45-60 minute structured face-to-face training covering osteoporosis definition, risk factors, and prevention through nutrition and exercise. Digital Support: A 4-week follow-up via WhatsApp, involving twice-weekly distribution of educational videos, digital brochures, and podcasts to reinforce healthy behaviors. 3. Final Assessment: Four weeks post-intervention, both groups repeat the baseline questionnaires. Control Group: Receives routine clinical information only. To prevent contamination, all educational materials are shared with this group only after the final data collection is completed.
Change in Osteoporosis Awareness Scale (OAS) score.
The Osteoporosis Awareness Scale (OAS) consists of 27 items with a total score ranging from a minimum of 27 to a maximum of 108, where higher scores indicate a greater level of osteoporosis awareness, representing a better outcome.
Change in Osteoporosis Health Belief Scale Score
The Total Osteoporosis Health Belief Scale (OHBS) score is the sum of 42 items ranging from 42 to 210, where higher scores indicate more positive health beliefs and stronger perceptions toward osteoporosis prevention, representing a better outcome.
Change in Osteoporosis Health Belief Scale - Perceived Seriousness Sub-dimension Score.
The Perceived Susceptibility sub-dimension (6 items) assesses the individual's perceived risk of developing osteoporosis with scores ranging from 6 to 30, where higher scores indicate a stronger perception of personal risk, representing a better outcome.
Change in Osteoporosis Health Belief Scale - Benefits of Exercise Sub-dimension Score.
The Barriers to Exercise sub-dimension (6 items) identifies perceived obstacles to regular physical activity with scores ranging from 6 to 30, where lower scores indicate fewer perceived barriers, representing a better outcome.
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