Health literacy and uptake of osteoporosis prevention recommendations in women — ASN Events
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Health literacy and uptake of osteoporosis prevention recommendations in women (#162)

Sarah M Hosking 1 , Julie A Pasco 1 2 3 , Alison Beauchamp 1 2 , Rachelle Buchbinder 2 4 , Lana J Williams 1 , Sharon L Brennan-Olsen 1 5 6
  1. Deakin University, Geelong, VIC, Australia
  2. Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
  3. Melbourne Medical School - Western Campus, The University of Melbourne, St Albans, VIC, Australia
  4. Monash Department of Clinical Epidemiology, Cabrini Institute, Malvern, VIC, Australia
  5. Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne, St Albans, VIC, Australia
  6. Institute of Healthy Ageing, Australian Catholic University, Melbourne, VIC, Australia

The uptake of best-practice recommendations for preventing osteoporosis is currently suboptimal. We investigated the role of health literacy in the uptake of prevention guidelines regarding physical activity (PA), smoking, alcohol consumption and dietary calcium.

Data were collected as part of the 15yr follow-up of women (age range 28.3-89.9yr) participating in the Geelong Osteoporosis Study, a population-based cohort located in south-eastern Australia. Health literacy was ascertained using the Health Literacy Questionnaire (HLQ), a multi-dimensional tool that generates scores across nine domains of health literacy (Figure)(1).

Current smoking and PA were self-reported: the latter on a 5-point mobility scale. Calcium and alcohol intake were determined by Food Frequency Questionnaire(2). Participants were considered to be meeting recommendations if they were a non-smoker, reported being ‘Active’ or ‘Vigorously Active’, met NHMRC Recommended Dietary Intake (RDI) for calcium and consumed ≤2 alcoholic drinks/day. Effect sizes (ES) were calculated for differences in mean HLQ domain scores between participants who did vs. did not meet each recommendation.

In our 676 women, 74.7% were sedentary, 10.4% were smokers, 24.1% consumed >2 standard drinks and 85.0% did not meet calcium RDIs. Meeting calcium RDI was associated with higher scores in domains relating to finding, or having, sufficient health information (ES 0.24, 95%CI 0.16-0.27; ES 0.30, 95%CI 0.20-0.35, respectively). Conversely, higher scores in domains that related to finding, having, and understanding health information were associated with exceeding alcohol intake recommendations. Lower scores for the domain of actively managing health were seen for smokers compared to non-smokers, and for lower PA (ES 0.62, 95%CI 0.54-0.66). All other domains, with the exception of ‘Feeling understood and supported by healthcare providers’ (ES 0.10, 95%CI 0.02-0.14), were also associated with lower PA, but with smaller ES.

These results suggest that certain health literacy domains are associated with uptake of osteoporosis prevention recommendations.

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References

  1. Osborne RH, et al. The grounded psychometric development and initial validation of the Health Literacy Questionnaire (HLQ). BMC Public Health. 2013 Jan;13(1):1–17.
  2. Hodge A, et al. The Anti Cancer Council of Victoria FFQ: relative validity of nutrient intakes compared with weighed food records in young to middle-aged women in a study of iron supplementation. Aust. N. Z. J. Public Health. 2000 Dec;24(6):576–83.