A Path Analysis Model Suggesting the Association of Information and Beliefs with Self-efficacy in Osteoporosis Prevention Among Middle-aged and Older Community Residents in Urban Shanghai, China

Background: Osteoporosis is a chronic disease whose prevention is more effective than treatment, but it may be necessary to change people's self-efficacy to prevent this condition. This article aimed to study the pathway among information, beliefs and self-efficacy in osteoporosis prevention, and support further intervention.

Methods: A cross-sectional study was conducted among community residents over 40 years old from two volunteer communities in urban Shanghai, China. Of 450 middle-aged and older community residents who volunteered to participate in the study, 421 (93.5%) finished the field survey effectively.

Results: 62.9% of the residents were females. Their mean age was 64.4 ± 11.2 years. The residents showed low knowledge of osteoporosis-related information, and the mean percentage of correct response was just 61.2%. In univariate analysis, information (univariate β = 0.27, 95% CI = 0.15-0.38) and beliefs (univariate β = 0.31, 95% CI = 0.25-0.38) were associated with self-efficacy. Multivariate analysis showed that information (multiple β = 0.19, 95% CI = 0.09-0.36) and belief (multiple β = 0.30, 95% CI = 0.23-0.36) remained significant. And in the path analysis, self-efficacy was significantly predicted by beliefs (β = 0.81, p<0.001).

Conclusions: The study highlighted the urgency of conducting the osteoporosis preventive health promotion among middle-aged and older people as their lack of information and low level of beliefs and self-efficacy about osteoporosis prevention. Future interventions should focus on improving beliefs, especially perceived benefits, perceived threats, and action clues, on osteoporosis prevention in this group.