Self-Efficacy Program to Prevent Osteoporosis
Among Chinese Immigrants
A Randomized Controlled Trial
Bing-Bing Qi 4 Barbara Resnick 4 Suzanne C. Smeltzer 4 Barker Bausell
b Background: Recent Chinese immigrants have a low bone
mineral density and are at a great risk for developing
osteoporosis.
The majority of Chinese men and women of
all ages have inadequate information about their risks for
developing osteoporosis and are seldom involved in preventive
activities.
b Objectives: The aim of this study was to evaluate the preliminary
effectiveness of an educational intervention based
on the self-efficacy theory aimed at increasing the knowledge
of osteoporosis and adoption of preventive behaviors,
including regular exercise and osteoporosis medication adherence,
designed for Chinese immigrants, aged 45 years
or above, living in the United States.
b Methods: A randomized controlled trial was employed, using a
repeated-measure design. Foreign-born Mandarin-speaking
Asians (n = 110) were recruited to the study, and 83 of them
(mean age = 64.08 years, SD = 9.48 years) were assigned
randomly to either the intervention group (n = 42) or the
attention control group (n = 41). There were 63 (75.9%)
women and 20 (24.1%) men. Data were collected at
baseline and 2 weeks after the intervention.
b Results: The participants who received the intervention had
statistically significant improvements (p G .05) at 2 weeks
postintervention with respect to osteoporosis-related knowledge,
self-efficacy for exercise, and osteoporosis medication
adherence. Moreover, the participants in the treatment group
spent more time on moderate exercise, had higher energy expenditure
on exercise, and had more osteoporosis medication
use at 2 weeks postintervention when compared with controls.
b Discussion: The intervention targeting Mandarin-speaking immigrants
was effective in increasing the knowledge of osteoporosis
and improving the adoption of preventive behaviors.
Future research is needed to explore the long-term effect of
this intervention on bone health behavior.
b Key Words: behavior change&Chinese immigrants & osteoporosis
Osteoporosis (OP), a major health problem for women
and men (National Osteoporosis Foundation [NOF],
2011), increases the risk of fractures of the hip, spine, and
wrist, resulting in pain, deformity, disability, costly rehabilitation,
poor quality of life, and even premature death (NOF,
2011). Asians have a rate of OP as high as Caucasians
do even after controlling for body mass index (Lynn, Lau,
Au, & Leung, 2005; Walker et al., 2006). It is predicted
that, by the year 2050, more than 50% of all hip fractures
will occur in the Asian population worldwide (Dhanwal,
Dennison, Harvey, & Cooper, 2011). In addition, there is
evidence that bone mineral density is lower among Asian
women and men who migrated to America later in life than
among those born in the United States (Tan et al., 2009;
Walker et al., 2006).
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