Concern and Risk Perception: Effects on Osteoprotective Behaviour

Table 4

Odds ratio (ORs) of bone mineral density (BMD) testing in the next 12 months for covariates about concern and risk perception of osteoporosis (limited to assessments with non-BMD testing in the previous year^!).

	Number (%)	Unadjusted OR; (95% CI)		Adjusted OR* (95% CI)
Concern about osteoporosis^#; (using a 3-point Likert scale)			0.002		0.35
Not at all concerned	86 (12.5)	1.00		1.00
Somewhat concerned	168 (15.8)	1.31 (0.99–1.73)		1.10 (0.80–1.51)
Very concerned	38 (21.7)	1.93 (1.26–2.96)		1.28 (0.77–2.13)
Perception of osteoporosis risk^#; (using a 5-point Likert scale)			0.001		0.03
Much lower	39 (9.9)	1.00		1.00
A little lower	78 (17.1)	1.87 (1.24–2.83)		1.75 (1.121–2.73)
About the same	122 (14.6)	1.55 (1.06–2.28)		1.40 (0.91–2.15)
A little higher	36 (20.9)	2.41 (1.47–3.96)		2.13 (1.21–3.75)
Much higher	12 (25.0)	2.99 (1.44–6.23)		2.53 (1.09–5.89)
Perception of fracture risk^#; (using a 5-point Likert scale)			0.004		0.03
Much lower	40 (9.9)	1.00		1.00
A little lower	85 (16.7)	1.83 (1.23–2.73)		1.59 (1.02–2.48)
About the same	139 (16.3)	1.78 (1.23–2.60)		1.70 (1.11–2.61)
A little higher	22 (17.7)	1.95 (1.11–3.43)		1.63 (0.85–3.14)
Much higher	6 (23.1)	2.63 (0.99–6.96)		2.57 (0.86–7.63)

Note: Each assessment was treated as an observation and lack of independence between assessments for the same women (clustering) was taken into account using generalized estimating equations.
^#Concern about osteoporosis (in thinking about your health, how concerned are you about osteoporosis?); perception of osteoporosis risk (how would you rate your own risk of “getting osteoporosis” compared to other women your age?); and perception of fracture risk (how would you rate your own risk of fracturing or breaking a bone compared to other women your age?).
*Adjusted for age, body mass index, private health insurance status, level of education, smoking, drinking, fracture since age 45 years, a maternal history of osteoporosis, history of fractured hip among parents, height loss since age 25 years (≥3 cms), weight loss (≥5 kgs) in the last year, self-reported health status, SF-36 physical score, current use of calcium and/or vitamin D, and seeking medical advice on osteoporosis in the previous year.
^∧Test for trend by treating groups as an ordered (continuous) variable.
^!Australian government provides subsided BMD testing once every two years for people at high fracture risk (e.g., prior fragility fracture, aged >70 years, and long-term glucocorticoid users).