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Published in: Osteoporosis International 9/2009

01-09-2009 | Original Article

Greater osteoporosis educational outreach is desirable among Chinese immigrants in Chinatown, Chicago

Authors: S. Tan, L. Ji, J. Tsai, J. Eng, H.-J. Ko, A. Yau, G. Edwards, A. Bunta, B. J. Edwards

Published in: Osteoporosis International | Issue 9/2009

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Abstract

Summary

Osteoporosis beliefs were assessed in immigrant Chinese women in Chinatown, Chicago. Results from a survey utilizing the Osteoporosis Health Belief Scale showed that women expressed concern about osteoporosis but lacked both knowledge of preventive care and health motivation.

Introduction

The objective of this study was to assess osteoporosis beliefs in immigrant Chinese women in Chinatown, Chicago.

Methods

In a community-based health fair, osteoporosis knowledge and self-efficacy among postmenopausal Chinese immigrants were assessed using the translated Osteoporosis Health Belief Scale. Bone mineral density (BMD) was assessed with calcaneal ultrasound.

Results

The study population included 94 women with mean age of 51 ± 9 years, mean length of residence in the United States of 9 ± 7 years, and 73% (n = 76) of whom were recent immigrants. Women expressed concern about the seriousness of osteoporosis and their relative susceptibility to osteoporosis. In particular, women with a prior fracture reported higher seriousness to osteoporosis. Nonetheless, women exhibited low health motivation and low awareness of the benefits of calcium and exercise. Bone densitometry results corresponded to a T score of −1.2 ± 1.5. Multiple regression analysis revealed that a younger age and longer length of residence in the USA were associated with higher BMD.

Conclusion

Chinese immigrant women in Chicago exhibit concern regarding osteoporosis, but are unaware of the benefits of calcium and exercise, and exhibit low health motivation. Chinese women in Chinatown lack necessary knowledge about osteoporosis to develop adequate self-efficacy. Public health initiatives should be undertaken among recent immigrant Chinese women.
Literature
1.
go back to reference National Institutes of Health Osteoporosis and Related Bone Disease (2006) Osteoporosis and Asian American women. National Institutes of Health Osteoporosis and Related Bone Disease, Bethesda, MD National Institutes of Health Osteoporosis and Related Bone Disease (2006) Osteoporosis and Asian American women. National Institutes of Health Osteoporosis and Related Bone Disease, Bethesda, MD
2.
go back to reference Siris E, Miller P, Barrett-Connor E, Faulkner K, Abbott T, Berger M, Santora A, Sherwood L (2001) Identification and fracture outcomes of undiagnosed low bone mineral density in postmenopausal women. JAMA 286:2815–2822PubMedCrossRef Siris E, Miller P, Barrett-Connor E, Faulkner K, Abbott T, Berger M, Santora A, Sherwood L (2001) Identification and fracture outcomes of undiagnosed low bone mineral density in postmenopausal women. JAMA 286:2815–2822PubMedCrossRef
3.
go back to reference Babbar R, Handa AB, Lo CM, Guttmacher S, Shindledecker R, Chung W, Fong C et al (2006) Bone health of immigrant Chinese women living in New York City. J Community Health 31:7–23PubMedCrossRef Babbar R, Handa AB, Lo CM, Guttmacher S, Shindledecker R, Chung W, Fong C et al (2006) Bone health of immigrant Chinese women living in New York City. J Community Health 31:7–23PubMedCrossRef
4.
go back to reference Walker M, Babber R, Opotowsky A, Rohira A, Nabizadeh F, Badia M, Chung W, Chiang J, Mediratta A, McMahon D, Liu G, Bilezikian JP (2006) A referent bone mineral density database for Chinese American women. Osteoporos Int 17:878–887PubMedCrossRef Walker M, Babber R, Opotowsky A, Rohira A, Nabizadeh F, Badia M, Chung W, Chiang J, Mediratta A, McMahon D, Liu G, Bilezikian JP (2006) A referent bone mineral density database for Chinese American women. Osteoporos Int 17:878–887PubMedCrossRef
5.
go back to reference Lauderdale DS, Kuohung V, Chang SL, Chin MH (2003) Identifying older Chinese immigrants at high risk for osteoporosis. J Gen Intern Med 18:508–515PubMedCrossRef Lauderdale DS, Kuohung V, Chang SL, Chin MH (2003) Identifying older Chinese immigrants at high risk for osteoporosis. J Gen Intern Med 18:508–515PubMedCrossRef
7.
go back to reference Chang S (2004) Explore the effectors of bone mineral density in community women. J Nurs Res 12:327–335PubMed Chang S (2004) Explore the effectors of bone mineral density in community women. J Nurs Res 12:327–335PubMed
8.
go back to reference Haines C, Rong L, Chung T, Leung D (1995) The perception of the menopause and the climacteric among women in Hong Kong and Southern China. Prev Med 24:245–248PubMedCrossRef Haines C, Rong L, Chung T, Leung D (1995) The perception of the menopause and the climacteric among women in Hong Kong and Southern China. Prev Med 24:245–248PubMedCrossRef
9.
go back to reference Sedlak C, Doheny MO, Estok PJ, Zeller RA, Winchell J (2007) DXA, health beliefs, and osteoporosis prevention behaviors. J Aging Health 18:742–756CrossRef Sedlak C, Doheny MO, Estok PJ, Zeller RA, Winchell J (2007) DXA, health beliefs, and osteoporosis prevention behaviors. J Aging Health 18:742–756CrossRef
10.
go back to reference Doheny M, Sedlak CA, Estok PJ, Zellar R (2007) Osteoporosis knowledge, health beliefs, and DXA T-scores in men and women 50 years of age and older. Orthop Nurs 26:243–250PubMedCrossRef Doheny M, Sedlak CA, Estok PJ, Zellar R (2007) Osteoporosis knowledge, health beliefs, and DXA T-scores in men and women 50 years of age and older. Orthop Nurs 26:243–250PubMedCrossRef
11.
go back to reference Jachna C, Forbes-Thompson S (2005) Osteoporosis: health beliefs and barriers to treatment in an assisted living facility. J Gerontol Nurs 31:24–30PubMed Jachna C, Forbes-Thompson S (2005) Osteoporosis: health beliefs and barriers to treatment in an assisted living facility. J Gerontol Nurs 31:24–30PubMed
12.
go back to reference Cline RR, Farley JF, Hansen RA, Schommer JC (2005) Osteoporosis beliefs and antiresorptive medication use. Maturitas 50:196–208PubMedCrossRef Cline RR, Farley JF, Hansen RA, Schommer JC (2005) Osteoporosis beliefs and antiresorptive medication use. Maturitas 50:196–208PubMedCrossRef
13.
go back to reference Johnson CS, McLeod W, Kennedy L, McLeod K (2007) Osteoporosis health beliefs among younger and older men and women. Health Educ Behav 35:721–733CrossRef Johnson CS, McLeod W, Kennedy L, McLeod K (2007) Osteoporosis health beliefs among younger and older men and women. Health Educ Behav 35:721–733CrossRef
14.
go back to reference Mauck KF, Cuddihy MT, Trousdale RT, Pond GR, Pankratz VS, Melton LJ 3rd (2002) The decision to accept treatment for osteoporosis following hip fracture: exploring the woman’s perspective using a stage-of-change model. Osteoporos Int 13:560–564PubMedCrossRef Mauck KF, Cuddihy MT, Trousdale RT, Pond GR, Pankratz VS, Melton LJ 3rd (2002) The decision to accept treatment for osteoporosis following hip fracture: exploring the woman’s perspective using a stage-of-change model. Osteoporos Int 13:560–564PubMedCrossRef
15.
go back to reference Cummings K, Jette AM, Rosenstock IM (1978) Construct validation of the health belief model. Health Educ Monogr 6:394–405PubMed Cummings K, Jette AM, Rosenstock IM (1978) Construct validation of the health belief model. Health Educ Monogr 6:394–405PubMed
16.
go back to reference Kim K, Horan ML, Gendler P, Patel MK (1991) Development and evaluation of osteoporosis health belief scale. Res Nurs Health 14:155–163PubMedCrossRef Kim K, Horan ML, Gendler P, Patel MK (1991) Development and evaluation of osteoporosis health belief scale. Res Nurs Health 14:155–163PubMedCrossRef
17.
go back to reference Hazavehei SM, Taghdisi MH, Saidi M (2007) Application of the health belief model for osteoporosis prevention among middle school girl students, Garmsar, Iran. Educ Health (Abingdon) 20:23 Hazavehei SM, Taghdisi MH, Saidi M (2007) Application of the health belief model for osteoporosis prevention among middle school girl students, Garmsar, Iran. Educ Health (Abingdon) 20:23
18.
go back to reference Tussing L, Chapman-Novakofski K (2005) Osteoporosis prevention education: behavior theories and calcium intake. J Am Diet Assoc 105:92–97PubMedCrossRef Tussing L, Chapman-Novakofski K (2005) Osteoporosis prevention education: behavior theories and calcium intake. J Am Diet Assoc 105:92–97PubMedCrossRef
19.
go back to reference Cadarette SM, Beaton DE, Hawker GA (2004) Osteoporosis health belief scale: minor changes were required after telephone administration among women. J Clin Epidemiol 57:154–166PubMedCrossRef Cadarette SM, Beaton DE, Hawker GA (2004) Osteoporosis health belief scale: minor changes were required after telephone administration among women. J Clin Epidemiol 57:154–166PubMedCrossRef
20.
go back to reference Weinstein ND, Lyon JE, Sandman PM, Cuite CL (1998) Experimental evidence for stages of health behavior change: the precaution adoption process model applied to home radon testing. Health Psychol 17:445–453PubMedCrossRef Weinstein ND, Lyon JE, Sandman PM, Cuite CL (1998) Experimental evidence for stages of health behavior change: the precaution adoption process model applied to home radon testing. Health Psychol 17:445–453PubMedCrossRef
21.
go back to reference Edwards BJ, Ferkel E, Iris M, Feinglass J (2006) Women who suffer a minimal trauma fracture are rarely apprised of the presence of low bone mass or osteoporosis. Maturitas 53:260–266PubMedCrossRef Edwards BJ, Ferkel E, Iris M, Feinglass J (2006) Women who suffer a minimal trauma fracture are rarely apprised of the presence of low bone mass or osteoporosis. Maturitas 53:260–266PubMedCrossRef
22.
go back to reference Prins S, Jørgensen HL, Jørgensen LV, Hassager C (1998) The role of quantitative ultrasound in the assessment of bone: a review. Clin Physiol 18:3–17PubMedCrossRef Prins S, Jørgensen HL, Jørgensen LV, Hassager C (1998) The role of quantitative ultrasound in the assessment of bone: a review. Clin Physiol 18:3–17PubMedCrossRef
23.
go back to reference Njeh CF, Nicholson PHF, Langton CM (1999) The physics of ultrasound applied to bone. In: Njeh CF (ed) Quantitative ultrasound. Martin Dunitz, London, pp 67–75 Njeh CF, Nicholson PHF, Langton CM (1999) The physics of ultrasound applied to bone. In: Njeh CF (ed) Quantitative ultrasound. Martin Dunitz, London, pp 67–75
24.
go back to reference Miller P, Siris ES, Barrett-Conner E, Faulkner KG, Wehren LE, Abbott TA, Chen YT et al (2002) Prediction of fracture risk in postmenopausal white women with peripheral bone densitometry: evidence from the National Osteoporosis Risk Assessment. J Bone Miner Res 17:2222–2230PubMedCrossRef Miller P, Siris ES, Barrett-Conner E, Faulkner KG, Wehren LE, Abbott TA, Chen YT et al (2002) Prediction of fracture risk in postmenopausal white women with peripheral bone densitometry: evidence from the National Osteoporosis Risk Assessment. J Bone Miner Res 17:2222–2230PubMedCrossRef
25.
go back to reference Personal communication from President of Chinese Benevolent Association of Chinatown and Susana Tan, 1 June 2008 Personal communication from President of Chinese Benevolent Association of Chinatown and Susana Tan, 1 June 2008
26.
go back to reference Wayne PM, Kiel DP, Krebs DE, Davis RB, Savetsky-German J, Connelly M, Buring JE (2007) The effects of Tai Chi on bone mineral density in postmenopausal women: a systematic review. Arch Phys Med Rehabil 88:673–680PubMedCrossRef Wayne PM, Kiel DP, Krebs DE, Davis RB, Savetsky-German J, Connelly M, Buring JE (2007) The effects of Tai Chi on bone mineral density in postmenopausal women: a systematic review. Arch Phys Med Rehabil 88:673–680PubMedCrossRef
27.
go back to reference Siris E, Miller P, Barrett-Connor E, Abbott T, Sherwood L, Berger M (1998) Design of NORA, the National Osteoporosis Risk Assessment program: a longitudinal US registry of postmenopausal women. Osteoporos Int 8(Suppl 1):S62–S69PubMed Siris E, Miller P, Barrett-Connor E, Abbott T, Sherwood L, Berger M (1998) Design of NORA, the National Osteoporosis Risk Assessment program: a longitudinal US registry of postmenopausal women. Osteoporos Int 8(Suppl 1):S62–S69PubMed
28.
go back to reference Pothiwala P, Evans EM, Chapman-Novakofski RD (2006) Ethnic variation in risk for osteoporosis among women: a review of biological and behavioral factors. J Womens Health 15:709–719CrossRef Pothiwala P, Evans EM, Chapman-Novakofski RD (2006) Ethnic variation in risk for osteoporosis among women: a review of biological and behavioral factors. J Womens Health 15:709–719CrossRef
29.
go back to reference Lynn H, Lau EMC, Au B, Leung PC (2005) Bone mineral density reference norms for Hong Kong Chinese. Osteoporosis Int 16:1663–1668CrossRef Lynn H, Lau EMC, Au B, Leung PC (2005) Bone mineral density reference norms for Hong Kong Chinese. Osteoporosis Int 16:1663–1668CrossRef
30.
go back to reference Ma G (2000) Barriers to the use of health services by Chinese Americans. J Allied Health 29:64–70PubMed Ma G (2000) Barriers to the use of health services by Chinese Americans. J Allied Health 29:64–70PubMed
31.
go back to reference Jang M, Lee E, Woo K (1998) Income, language, citizenship status: factors affecting the health care access and utilization of Chinese Americans. Health Soc Work 23:136–145PubMed Jang M, Lee E, Woo K (1998) Income, language, citizenship status: factors affecting the health care access and utilization of Chinese Americans. Health Soc Work 23:136–145PubMed
32.
go back to reference Tabora B, Flaskerus JH (1997) Mental health beliefs, practices, and knowledge of Chinese American immigrant women. Issues Ment Health Nurs 18:173–189PubMedCrossRef Tabora B, Flaskerus JH (1997) Mental health beliefs, practices, and knowledge of Chinese American immigrant women. Issues Ment Health Nurs 18:173–189PubMedCrossRef
34.
go back to reference Prochaska JO, Velicer WF, Diclemente CC, Fava J (1988) Measuring processes of change: applications to the cessation of smoking. J Consult Clin Psychol 56:520–528PubMedCrossRef Prochaska JO, Velicer WF, Diclemente CC, Fava J (1988) Measuring processes of change: applications to the cessation of smoking. J Consult Clin Psychol 56:520–528PubMedCrossRef
35.
go back to reference Walters V (1992) Women’s views of their main health problems. Can J Public Health 83:371–374PubMed Walters V (1992) Women’s views of their main health problems. Can J Public Health 83:371–374PubMed
37.
go back to reference Orimo H, Hashimoto T, Sakata K, Yoshimura N, Suzuki T, Hosoi T (2000) Trends in the incidence of hip fracture in Japan, 1987–1997: the third nationwide survey. J Bone Miner Metab 18:126–131PubMedCrossRef Orimo H, Hashimoto T, Sakata K, Yoshimura N, Suzuki T, Hosoi T (2000) Trends in the incidence of hip fracture in Japan, 1987–1997: the third nationwide survey. J Bone Miner Metab 18:126–131PubMedCrossRef
38.
go back to reference Moayyeri A, Soltani A, Larijani B, Naghavi M, Alaeddini F, Abolhassani F (2006) Epidemiology of hip fracture in Iran: results from the Iranian Multicenter Study on Accidental Injuries. Osteoporos Int 17:1252–1257PubMedCrossRef Moayyeri A, Soltani A, Larijani B, Naghavi M, Alaeddini F, Abolhassani F (2006) Epidemiology of hip fracture in Iran: results from the Iranian Multicenter Study on Accidental Injuries. Osteoporos Int 17:1252–1257PubMedCrossRef
40.
go back to reference Schwartz AV, Kelsey JL, Maggi S, Tuttleman M, Ho SC, Jónsson PV, Poór G, Sisson de Castro JA, Xu L, Matkin CC, Nelson LM, Heyse SP (1999) International variation in the incidence of hip fractures: cross-national project on osteoporosis for the World Health Organization Program for Research on Aging. Osteoporos Int 9:242–253PubMedCrossRef Schwartz AV, Kelsey JL, Maggi S, Tuttleman M, Ho SC, Jónsson PV, Poór G, Sisson de Castro JA, Xu L, Matkin CC, Nelson LM, Heyse SP (1999) International variation in the incidence of hip fractures: cross-national project on osteoporosis for the World Health Organization Program for Research on Aging. Osteoporos Int 9:242–253PubMedCrossRef
41.
go back to reference Cummings SR, Cauley JA, Palermo L, Ross PD, Wasnich RD, Black D, Faulkner KG (1994) Racial differences in hip axis lengths might explain racial differences in rates of hip fracture. Study of Osteoporotic Fractures Research Group. Osteoporos Int 4:226–229PubMedCrossRef Cummings SR, Cauley JA, Palermo L, Ross PD, Wasnich RD, Black D, Faulkner KG (1994) Racial differences in hip axis lengths might explain racial differences in rates of hip fracture. Study of Osteoporotic Fractures Research Group. Osteoporos Int 4:226–229PubMedCrossRef
42.
go back to reference Nakamura T, Turner CH, Yoshikawa T, Slemenda CW, Peacock M, Burr DB, Mizuno Y, Orimo H, Ouchi Y, Johnston CC Jr (1994) Do variations in hip geometry explain differences in hip fracture risk between Japanese and white Americans. J Bone Miner Res 9:1071–1076PubMedCrossRef Nakamura T, Turner CH, Yoshikawa T, Slemenda CW, Peacock M, Burr DB, Mizuno Y, Orimo H, Ouchi Y, Johnston CC Jr (1994) Do variations in hip geometry explain differences in hip fracture risk between Japanese and white Americans. J Bone Miner Res 9:1071–1076PubMedCrossRef
43.
go back to reference Siris ES, Brenneman SK, Miller PD, Barrett-Connor E, Chen YT, Sherwood LM, Abbott TA (2004) Predictive value of low BMD for 1-year fracture outcomes is similar for postmenopausal women ages 50–64 and 65 and older: results from the National Osteoporosis Risk Assessment (NORA). J Bone Miner Res 19:1215–1220PubMedCrossRef Siris ES, Brenneman SK, Miller PD, Barrett-Connor E, Chen YT, Sherwood LM, Abbott TA (2004) Predictive value of low BMD for 1-year fracture outcomes is similar for postmenopausal women ages 50–64 and 65 and older: results from the National Osteoporosis Risk Assessment (NORA). J Bone Miner Res 19:1215–1220PubMedCrossRef
Metadata
Title
Greater osteoporosis educational outreach is desirable among Chinese immigrants in Chinatown, Chicago
Authors
S. Tan
L. Ji
J. Tsai
J. Eng
H.-J. Ko
A. Yau
G. Edwards
A. Bunta
B. J. Edwards
Publication date
01-09-2009
Publisher
Springer-Verlag
Published in
Osteoporosis International / Issue 9/2009
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-008-0828-3

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