Knowledge, Awareness and Perception towards Osteoporosis Risk in China: A Systematic Review
-
Li Wang
,
liyongjin Li
,
Jiali Gu
,
Li Xiao
,
Jiayang Wang
Abstract
Background: We aimed to evaluate the level of knowledge, awareness, and perceptions regarding osteoporosis (OP) and risk factors in China.
Methods: The databases of PubMed, Medline, Embase, Web of science, VIP, and CNKI were searched for papers published before December 2022 using Chinese and English keywords and their combinations: “knowledge”, “osteoporosis”, “risk factor”, “bone health”, “perception”, “awareness”. The levels of knowledge, awareness, and perception about OP, as well as risk factors, clinical symptoms, and health information sources were narratively synthesized.
Results: Sixteen papers were finally included for analysis. Participants all showed poor levels of knowledge and perception regarding osteoporosis and risk factors. Investigation of clinical symptoms was rarely involved in the included studies due to the asymptomatic features of OP. The findings also suggest a strong association between poor level of knowledge regarding OP and educational attainment, type of participant, and gender. The majority of participants are increasingly turning to the Internet and social media to access information about OP.
Conclusion: The findings of this paper provide useful information for intervention providers to prevent and control OP and encourage them to carry out health promotion campaigns to enhance knowledge and awareness of OP.
1. Eastell R (2017). Prevention and management of osteoporosis. Medicine,45(9):565-9.
2. von Hurst PR, Wham CA (2007). Attitudes and knowledge about osteoporosis risk prevention: a survey of New Zealand women. Public Health Nutr,10(7):747-53.
3. WHO (2003). Prevention and management of osteoporosis : report of a WHO scientific group (No. 921). Geneva: World Health Organization. https://pubmed.ncbi.nlm.nih.gov/15293701/
4. Wade SW, Strader C, Fitzpatrick LA, et al (2014). Estimating prevalence of osteoporosis: examples from industrialized countries. Arch Osteoporos,9:182.
5. Yu F, Xia W (2019). The epidemiology of osteoporosis, associated fragility fractures, and management gap in China. Arch Osteoporos,14(1):32.
6. Hernlund E, Svedbom A, Ivergård M, et al (2013). Osteoporosis in the European Union: medical management, epidemiology and economic burden. A report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Arch Osteoporos,8(1):136.
7. Boateng D, Wekesah F, Browne JL, et al (2017). Knowledge and awareness of and perception towards cardiovascular disease risk in sub-Saharan Africa: A systematic review. PLoS One,12(12):e0189264.
8. Page MJ, McKenzie JE, Bossuyt PM, et al (2021). The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ,372:n71.
9. (CASP) CASP. Critical Appraisal Skills Programme (CASP) Qualitative Research Checklist [Available from: http://media.wix.com/ugd/dded87_29c5b002d99342f788c6ac670e49f274.pdf
10. Health NIo. [Available from: https://www.nhlbi.nih.gov/health-topics/study-quality-assessment-tools
11. Pedersen VH, Dagenais P, Lehoux P (2011). Multi-source synthesis of data to inform health policy. Int J Technol Assess Health Care,27(3):238-46.
12. Oumer KS, Liu Y, Yu Q, et al (2020). Awareness of osteoporosis among 368 residents in China: a cross-sectional study. BMC Musculoskelet Disord,21(1):197.
13. Ip TP, Lam CL, Kung AW (2004). Awareness of osteoporosis among physicians in China. Osteoporos Int,15(4):329-34.
14. Wong CP, Lok MK, Wun YT, et al (2014). Chinese men's knowledge and risk factors of osteoporosis: compared with women's. Am J Mens Health,8(2):159-66.
15. Zhang YP, Xia RY, Zhang B, et al (2014). Gender differences on osteoporosis health beliefs and related behaviors in non-academic community Chinese. J Community Health,39(3):545-51.
16. Peng L, Reynolds N, He A, et al (2020). Osteoporosis knowledge and related factors among orthopedic nurses in Hunan province of China. Int J Orthop Trauma Nurs,36:100714.
17. Hsieh E, Fraenkel L, Bradley EH, et al (2014). Osteoporosis knowledge, self-efficacy, and health beliefs among Chinese individuals with HIV. Arch Osteoporos,9(1):201.
18. Fok M, Leung HB, Lee WM (2008). Osteoporosis: public awareness, commitment, and perspectives. Hong Kong Med J,14(3):203-8.
19. Xu J, Sun M, Wang Z, et al (2013). Awareness of osteoporosis and its relationship with calcaneus quantitative ultrasound in a large Chinese community population. Clin Interv Aging,8:789-96.
20. Lee LY-K, Lai EK-F (2006). Osteoporosis in older Chinese men: knowledge and health beliefs. J Clin Nursing,15(3):353-5.
21. Zhang YP, Li XM, Wang DL, et al (2012). Evaluation of educational program on osteoporosis awareness and prevention among nurse students in China. Nurs Health Sci,14(1):74-80.
22. Xie B, Tian J, Zhou D, et al (2014). Analysis of the questionnaire of osteoporosis knowledge in postmenopausal women in Liaoning area. Chin J Osteoporos,(1):73-7.
23. Shen Y, Zhu C, Shen M, et al (2006). The analysis of questionnaire survey related to osteoporosis. Modern Prev Med,33(8):1419-20,26.
24. Du R, Wang C (2014). Investigation on the knowledge of osteoporosis among people aged ≥50 years. Chin J Public Health,30(1):118-9.
25. Guo X, Dong B, Yao J (2018). Survey osteoporosis related knowledge and service demand of people with abnormal bone density. Chin Nurs Res,32(4):608-10.
26. He B, Zhang W, Lu N, et al (2012). Investigation and analysis of relative knowledge of osteoporotic fracture with different risk degree in elderly female residents. Chin J Osteoporos,18(1):71-7.
27. Zheng W, Zhang W, Zhang L, et al (2015). Study on the obtaining situation of osteoporotic fractures related knowledge and influencing factors of the nurses. Chongqing Medicine,44(15):2093-5.
28. Caprio GG, Picascia D, Dallio M, et al (2020). Light Alcohol Drinking and the Risk of Cancer Development: A Controversial Relationship. Rev Recent Clin Trials,15(3):164-77.
29. Siri-Tarino PW, Krauss RM (2016). Diet, lipids, and cardiovascular disease. Curr Opin Lipidol,27(4):323-8.
30. College R. Health Issues Specific to Women's Health [Available from: https://online.regiscollege.edu/online-masters-degrees/online-master-science-nursing/womens-health-nurse-practitioner/resources/health-issues-specific-womens-health/
31. Thulkar J, Singh S (2015). Overview of research studies on osteoporosis in menopausal women since the last decade. J Midlife Health,6(3):104-7.
32. Kronzer VL, Crowson CS, Sparks JA, et al (2021). Family History of Rheumatic, Autoimmune, and Nonautoimmune Diseases and Risk of Rheumatoid Arthritis. Arthritis Care Res (Hoboken),73(2):180-7.
33. Wang Y, Ding H, Wang X, et al (2019). Associated Factors for Osteoporosis and Fracture in Chinese Elderly. Med Sci Monit,25:5580-8.
34. Cauley JA, Nelson DA. Chapter 19 - Race, ethnicity, and osteoporosis. In: Dempster DW, Cauley JA, Bouxsein ML, Cosman F, editors. Marcus and Feldman's Osteoporosis (Fifth Edition): Academic Press; 2021. p. 453-75.
35. Berg KM, Kunins HV, Jackson JL, et al (2008). Association between alcohol consumption and both osteoporotic fracture and bone density. Am J Med,121(5):406-18.
36. Gaddini GW, Turner RT, Grant KA, et al (2016). Alcohol: A Simple Nutrient with Complex Actions on Bone in the Adult Skeleton. Alcohol Clin Exp Res,40(4):657-71.
37. Cheraghi Z, Doosti-Irani A, Almasi-Hashiani A, et al (2019). The effect of alcohol on osteoporosis: A systematic review and meta-analysis. Drug Alcohol Depend,197:197-202.
38. Sarich P, Canfell K, Egger S, et al (2021). Alcohol consumption, drinking patterns and cancer incidence in an Australian cohort of 226,162 participants aged 45 years and over. Br J Cancer,124(2):513-23.
39. Rock CL, Thomson C, Gansler T, et al (2020). American Cancer Society guideline for diet and physical activity for cancer prevention. CA Cancer J Clin,70(4):245-71.
40. Zhao L-J, Jiang H, Papasian CJ, et al (2008). Correlation of Obesity and Osteoporosis: Effect of Fat Mass on the Determination of Osteoporosis. J Bone Miner Res,23(1):17-29.
41. Harding AT, Beck BR (2017). Exercise, Osteoporosis, and Bone Geometry. Sports,5(2):29.
42. McNaughton SA, Wattanapenpaiboon N, Wark JD, et al (2011). An Energy-Dense, Nutrient-Poor Dietary Pattern Is Inversely Associated with Bone Health in Women. J Nutr,141(8):1516-23.
43. Staff MC. Exercising with osteoporosis: Stay active the safe way 2021 [Available from: https://www.mayoclinic.org/diseases-conditions/osteoporosis/in-depth/osteoporosis/art-20044989
44. Moreira LD, Oliveira ML, Lirani-Galvão AP, et al (2014). Physical exercise and osteoporosis: effects of different types of exercises on bone and physical function of postmenopausal women. Arq Bras Endocrinol Metabol,58(5):514-22.
45. McCabe LD, Martin BR, McCabe GP, et al (2004). Dairy intakes affect bone density in the elderly. Am J Clin Nutr,80(4):1066-74.
46. 4Hu D, Cheng L, Jiang W (2018). Fruit and vegetable consumption and the risk of postmenopausal osteoporosis: a meta-analysis of observational studies. Food Funct,9(5):2607-16.
47. Chen YM, Ho SC, Lam SS (2010). Higher sea fish intake is associated with greater bone mass and lower osteoporosis risk in postmenopausal Chinese women. Osteoporos Int,21(6):939-46.
48. Dai Z, Jin A, Soh AZ, et al (2018). Coffee and tea drinking in relation to risk of hip fracture in the Singapore Chinese Health Study. Bone,112:51-7.
49. Hallström H, Wolk A, Glynn A, et al (2006). Coffee, tea and caffeine consumption in relation to osteoporotic fracture risk in a cohort of Swedish women. Osteoporos Int,17(7):1055-64.
50. Das UN (2013). Catechins and osteoporosis. Nutrition,29(4):697-9.
51. Ringe JD (2020). Plain vitamin D or active vitamin D in the treatment of osteoporosis: where do we stand today? Arch Osteoporos,15(1):182.
52. Liu C, Kuang X, Li K, et al (2020). Effects of combined calcium and vitamin D supplementation on osteoporosis in postmenopausal women: a systematic review and meta-analysis of randomized controlled trials. Food Funct,11(12):10817-27.
53. Tucker KL, Morita K, Qiao N, et al (2006). Colas, but not other carbonated beverages, are associated with low bone mineral density in older women: The Framingham Osteoporosis Study. Am J Clin Nutr,84(4):936-42.
54. Wang L, Li Y (2021). The impact of communication on women's risk perceptions for osteoporosis in China. Women Health,61(9):845-53.
55. Covello VT, Peters RG (2002). Women's perceptions of the risks of age-related diseases, including breast cancer: reports from a 3-year research study. Health Commun,14(3):377-95.
56. Li J, Tang J, Liu X, et al (2019). How do users adopt health information from social media? The narrative paradigm perspective. Health Inf Manag,48(3):116-26.
2. von Hurst PR, Wham CA (2007). Attitudes and knowledge about osteoporosis risk prevention: a survey of New Zealand women. Public Health Nutr,10(7):747-53.
3. WHO (2003). Prevention and management of osteoporosis : report of a WHO scientific group (No. 921). Geneva: World Health Organization. https://pubmed.ncbi.nlm.nih.gov/15293701/
4. Wade SW, Strader C, Fitzpatrick LA, et al (2014). Estimating prevalence of osteoporosis: examples from industrialized countries. Arch Osteoporos,9:182.
5. Yu F, Xia W (2019). The epidemiology of osteoporosis, associated fragility fractures, and management gap in China. Arch Osteoporos,14(1):32.
6. Hernlund E, Svedbom A, Ivergård M, et al (2013). Osteoporosis in the European Union: medical management, epidemiology and economic burden. A report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Arch Osteoporos,8(1):136.
7. Boateng D, Wekesah F, Browne JL, et al (2017). Knowledge and awareness of and perception towards cardiovascular disease risk in sub-Saharan Africa: A systematic review. PLoS One,12(12):e0189264.
8. Page MJ, McKenzie JE, Bossuyt PM, et al (2021). The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ,372:n71.
9. (CASP) CASP. Critical Appraisal Skills Programme (CASP) Qualitative Research Checklist [Available from: http://media.wix.com/ugd/dded87_29c5b002d99342f788c6ac670e49f274.pdf
10. Health NIo. [Available from: https://www.nhlbi.nih.gov/health-topics/study-quality-assessment-tools
11. Pedersen VH, Dagenais P, Lehoux P (2011). Multi-source synthesis of data to inform health policy. Int J Technol Assess Health Care,27(3):238-46.
12. Oumer KS, Liu Y, Yu Q, et al (2020). Awareness of osteoporosis among 368 residents in China: a cross-sectional study. BMC Musculoskelet Disord,21(1):197.
13. Ip TP, Lam CL, Kung AW (2004). Awareness of osteoporosis among physicians in China. Osteoporos Int,15(4):329-34.
14. Wong CP, Lok MK, Wun YT, et al (2014). Chinese men's knowledge and risk factors of osteoporosis: compared with women's. Am J Mens Health,8(2):159-66.
15. Zhang YP, Xia RY, Zhang B, et al (2014). Gender differences on osteoporosis health beliefs and related behaviors in non-academic community Chinese. J Community Health,39(3):545-51.
16. Peng L, Reynolds N, He A, et al (2020). Osteoporosis knowledge and related factors among orthopedic nurses in Hunan province of China. Int J Orthop Trauma Nurs,36:100714.
17. Hsieh E, Fraenkel L, Bradley EH, et al (2014). Osteoporosis knowledge, self-efficacy, and health beliefs among Chinese individuals with HIV. Arch Osteoporos,9(1):201.
18. Fok M, Leung HB, Lee WM (2008). Osteoporosis: public awareness, commitment, and perspectives. Hong Kong Med J,14(3):203-8.
19. Xu J, Sun M, Wang Z, et al (2013). Awareness of osteoporosis and its relationship with calcaneus quantitative ultrasound in a large Chinese community population. Clin Interv Aging,8:789-96.
20. Lee LY-K, Lai EK-F (2006). Osteoporosis in older Chinese men: knowledge and health beliefs. J Clin Nursing,15(3):353-5.
21. Zhang YP, Li XM, Wang DL, et al (2012). Evaluation of educational program on osteoporosis awareness and prevention among nurse students in China. Nurs Health Sci,14(1):74-80.
22. Xie B, Tian J, Zhou D, et al (2014). Analysis of the questionnaire of osteoporosis knowledge in postmenopausal women in Liaoning area. Chin J Osteoporos,(1):73-7.
23. Shen Y, Zhu C, Shen M, et al (2006). The analysis of questionnaire survey related to osteoporosis. Modern Prev Med,33(8):1419-20,26.
24. Du R, Wang C (2014). Investigation on the knowledge of osteoporosis among people aged ≥50 years. Chin J Public Health,30(1):118-9.
25. Guo X, Dong B, Yao J (2018). Survey osteoporosis related knowledge and service demand of people with abnormal bone density. Chin Nurs Res,32(4):608-10.
26. He B, Zhang W, Lu N, et al (2012). Investigation and analysis of relative knowledge of osteoporotic fracture with different risk degree in elderly female residents. Chin J Osteoporos,18(1):71-7.
27. Zheng W, Zhang W, Zhang L, et al (2015). Study on the obtaining situation of osteoporotic fractures related knowledge and influencing factors of the nurses. Chongqing Medicine,44(15):2093-5.
28. Caprio GG, Picascia D, Dallio M, et al (2020). Light Alcohol Drinking and the Risk of Cancer Development: A Controversial Relationship. Rev Recent Clin Trials,15(3):164-77.
29. Siri-Tarino PW, Krauss RM (2016). Diet, lipids, and cardiovascular disease. Curr Opin Lipidol,27(4):323-8.
30. College R. Health Issues Specific to Women's Health [Available from: https://online.regiscollege.edu/online-masters-degrees/online-master-science-nursing/womens-health-nurse-practitioner/resources/health-issues-specific-womens-health/
31. Thulkar J, Singh S (2015). Overview of research studies on osteoporosis in menopausal women since the last decade. J Midlife Health,6(3):104-7.
32. Kronzer VL, Crowson CS, Sparks JA, et al (2021). Family History of Rheumatic, Autoimmune, and Nonautoimmune Diseases and Risk of Rheumatoid Arthritis. Arthritis Care Res (Hoboken),73(2):180-7.
33. Wang Y, Ding H, Wang X, et al (2019). Associated Factors for Osteoporosis and Fracture in Chinese Elderly. Med Sci Monit,25:5580-8.
34. Cauley JA, Nelson DA. Chapter 19 - Race, ethnicity, and osteoporosis. In: Dempster DW, Cauley JA, Bouxsein ML, Cosman F, editors. Marcus and Feldman's Osteoporosis (Fifth Edition): Academic Press; 2021. p. 453-75.
35. Berg KM, Kunins HV, Jackson JL, et al (2008). Association between alcohol consumption and both osteoporotic fracture and bone density. Am J Med,121(5):406-18.
36. Gaddini GW, Turner RT, Grant KA, et al (2016). Alcohol: A Simple Nutrient with Complex Actions on Bone in the Adult Skeleton. Alcohol Clin Exp Res,40(4):657-71.
37. Cheraghi Z, Doosti-Irani A, Almasi-Hashiani A, et al (2019). The effect of alcohol on osteoporosis: A systematic review and meta-analysis. Drug Alcohol Depend,197:197-202.
38. Sarich P, Canfell K, Egger S, et al (2021). Alcohol consumption, drinking patterns and cancer incidence in an Australian cohort of 226,162 participants aged 45 years and over. Br J Cancer,124(2):513-23.
39. Rock CL, Thomson C, Gansler T, et al (2020). American Cancer Society guideline for diet and physical activity for cancer prevention. CA Cancer J Clin,70(4):245-71.
40. Zhao L-J, Jiang H, Papasian CJ, et al (2008). Correlation of Obesity and Osteoporosis: Effect of Fat Mass on the Determination of Osteoporosis. J Bone Miner Res,23(1):17-29.
41. Harding AT, Beck BR (2017). Exercise, Osteoporosis, and Bone Geometry. Sports,5(2):29.
42. McNaughton SA, Wattanapenpaiboon N, Wark JD, et al (2011). An Energy-Dense, Nutrient-Poor Dietary Pattern Is Inversely Associated with Bone Health in Women. J Nutr,141(8):1516-23.
43. Staff MC. Exercising with osteoporosis: Stay active the safe way 2021 [Available from: https://www.mayoclinic.org/diseases-conditions/osteoporosis/in-depth/osteoporosis/art-20044989
44. Moreira LD, Oliveira ML, Lirani-Galvão AP, et al (2014). Physical exercise and osteoporosis: effects of different types of exercises on bone and physical function of postmenopausal women. Arq Bras Endocrinol Metabol,58(5):514-22.
45. McCabe LD, Martin BR, McCabe GP, et al (2004). Dairy intakes affect bone density in the elderly. Am J Clin Nutr,80(4):1066-74.
46. 4Hu D, Cheng L, Jiang W (2018). Fruit and vegetable consumption and the risk of postmenopausal osteoporosis: a meta-analysis of observational studies. Food Funct,9(5):2607-16.
47. Chen YM, Ho SC, Lam SS (2010). Higher sea fish intake is associated with greater bone mass and lower osteoporosis risk in postmenopausal Chinese women. Osteoporos Int,21(6):939-46.
48. Dai Z, Jin A, Soh AZ, et al (2018). Coffee and tea drinking in relation to risk of hip fracture in the Singapore Chinese Health Study. Bone,112:51-7.
49. Hallström H, Wolk A, Glynn A, et al (2006). Coffee, tea and caffeine consumption in relation to osteoporotic fracture risk in a cohort of Swedish women. Osteoporos Int,17(7):1055-64.
50. Das UN (2013). Catechins and osteoporosis. Nutrition,29(4):697-9.
51. Ringe JD (2020). Plain vitamin D or active vitamin D in the treatment of osteoporosis: where do we stand today? Arch Osteoporos,15(1):182.
52. Liu C, Kuang X, Li K, et al (2020). Effects of combined calcium and vitamin D supplementation on osteoporosis in postmenopausal women: a systematic review and meta-analysis of randomized controlled trials. Food Funct,11(12):10817-27.
53. Tucker KL, Morita K, Qiao N, et al (2006). Colas, but not other carbonated beverages, are associated with low bone mineral density in older women: The Framingham Osteoporosis Study. Am J Clin Nutr,84(4):936-42.
54. Wang L, Li Y (2021). The impact of communication on women's risk perceptions for osteoporosis in China. Women Health,61(9):845-53.
55. Covello VT, Peters RG (2002). Women's perceptions of the risks of age-related diseases, including breast cancer: reports from a 3-year research study. Health Commun,14(3):377-95.
56. Li J, Tang J, Liu X, et al (2019). How do users adopt health information from social media? The narrative paradigm perspective. Health Inf Manag,48(3):116-26.
| Files | ||
| Issue | Vol 53 No 5 (2024) | |
| Section | Review Article(s) | |
| DOI | https://doi.org/10.18502/ijph.v53i5.15581 | |
| Keywords | ||
| Osteoporosis Risk factors Awareness Risk perception Knowledge | ||
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How to Cite
1.
Wang L, Li liyongjin, Gu J, Xiao L, Wang J. Knowledge, Awareness and Perception towards Osteoporosis Risk in China: A Systematic Review. Iran J Public Health. 2024;53(5):1009-1020.
