Poster Presentation ESA-SRB-ANZBMS 2024 in conjunction with ENSA

Developing a questionnaire to assess knowledge, attitudes, and intentions related to osteoporosis and bone health in at-risk Australian adults: A Delphi Study. (#365)

Jocelyn Livia 1 , Satvinder S Dhaliwal 2 3 , Christina M Pollard 1 , Jonine Jancey 4 , Kun (Kathy) Zhu 5 6 , Sandra Iuliano 7 , Belinda Beck 8 , Robin M Daly 9 , Joshua R Lewis 5 10 , Cherie Chiang 11 , Amanda Devine 10 , Richard L Prince 5 10 , Deborah A Kerr 1 3
  1. School of Population Health, Curtin University, Bentley, Western Australia, Australia
  2. Duke-NUS Medical School, National University of Singapore, Singapore
  3. Curtin Health Innovation Research Institute, Curtin University, Bentley, Western Australia, Australia
  4. CERIIPH, Curtin School of Population Health, Curtin University, Bentley, Western Australia, Australia
  5. The University of Western Australia Medical School, The University of Western Australia, Nedlands, Western Australia, Australia
  6. Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Perth, Western, Australia
  7. Departments of Endocrinology and Medicine, Austin Health, University of Melbourne, Heidelberg, Victoria, Australia
  8. School of Health Sciences and Social Work, Griffith University, Gold Coast Campus, Gold Coast, Queensland, Australia
  9. Institute for Physical Activity and Nutrition, Deakin University, Burwood, Victoria, Australia
  10. Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
  11. University of Melbourne, Royal Melbourne Hospital, Parkville, Victoria, Australia

Background and Aims:

Osteoporosis remains essentially underdiagnosed and despite treatment and screening programs rates remain poor, even in those who have already sustained their first fragility fracture [1]. There are limited validated questionnaires to assess community knowledge and concerns about osteoporosis. This study aimed to develop and validate a questionnaire using the Delphi technique to assess older adults’ knowledge, attitudes and intentions related to osteoporosis.

Methods:

The Delphi technique used four phases: item development, content validity, item difficulty, and construct validity. Experts (n=9) reviewed and refined questions on risk factor knowledge, attitudes and intentions, rated the relevance of each question, and whether items should be kept, modified or deleted. Questions with agreement of < 75% were included in subsequent rounds.  Forty-three community participants aged ≥ 50 years were then assessed on their understanding of each item (1 = very difficult, 5 = very easy). Construct validity for knowledge items (% correct true/false responses) between experts and participants was set at ≥80% = too easy, <20% = too difficult.

Results:

After four rounds, 22 items achieved expert consensus. Participants rated item difficulty at 4.5 ± 0.1, indicating questions were easy to understand. Construct validity for knowledge items achieved 61% but varied across topics, from “knowledge of calcium sources” (73%), “risk of osteoporosis” (69%), to “risk of vitamin D deficiency” (45%), indicating the questions discriminated between common misconceptions and lack of knowledge of osteoporosis. Variations also occurred within topics, e.g. for “exercises beneficial for preventing osteoporosis”, 30% of participants incorrectly selected swimming as beneficial.

 

Conclusions:

The Delphi process successfully validated a questionnaire exploring older adults’ knowledge, attitudes and intentions related to osteoporosis. Common uncertainties identified among participants suggest the instrument is suitable for research to inform the development of public health strategies to reduce osteoporosis risk.