@2024 Afarand., IRAN

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ISSN: 2383-2150    Journal of Education and Community Health 2015;2(2):47-55

Background
Osteoporosis is a metabolic bone disorder[1] that with the reduction in strength and bone density increases the bone fracture and reduces their mechanical strength [2].
Previous Studies
… [3-12].Training osteoporosis preventive behaviors in adolescents can reduce the incidence of this disease in the elderly[13]. …[14-18].
Aim(s)
The aim of this study was to evaluate the effect of education on the prevention of osteoporosis on knowledge, attitudes and behaviors of adolescent girl students in Kermanshah.
Research type
This study is a quasi-experimental intervention study
Research society, place and time
The study was carried out among secondary school female students in two schools i.e. “Hejab” and “Danesh” in Kermanshah in the academic year 2012-2013.
Sampling method and number
Samples were selected using a three-stage cluster sampling. First,among three districts of Kermanshah, school in the third district, were selected by cluster sampling. A list of girl Junior high schools in this area was prepared and two schools were selected randomly from the two schools. Between the two selected schools, one school was selected randomly as a control group and the other school was selected as the interventional group. In the schools, also, the third grade of junior high school was randomly selected and among the third year of junior high school, in each school, two classes were randomly selected. Inclusion criteria included the third grade junior high school selected students and the exclusion criteria was the students` or their parents` disagreement to participate in the study. The number of samples was calculated 50 in each group that considering the drop percent, 118 students (53 persons in the interventional group and 65 people in the control group) were selected.
Used devices&materials
In order to collect data related to knowledge, attitude, and behavior Menshadi et al. questionnaire was used [19]. In the mentioned study, the scale has been investigated in terms of face and content validity as well as reliability (Cronbach alpha 0.81). The questionnaire used in this study included four sections: the first part included 12 questions about demographic and background information. The second section (cronbach alpha=0.83) included 14 questions for measuring knowledge that was evaluated with the continuum of three options of “yes”, “no” and “I don`t know”. 2, 1, and 0 scores were considered for correct responses, “I don`t know answers”, and wrong answers respectively. The range score was 0-28 and the higher score indicated more knowledge among the girls. The third part included 11 questions regarding the adolescent`s attitude that was investigated with the continuum of responses included totally agree (+4 scores), agree (+3 scores), disagree (2 scores), and totally disagree (+1 score). Internal consistency of this section was 0.76 and the range score was 11-44 that the higher score indicated more positive attitude. The fourth section included 9 questions about the osteoporosis preventive behaviors. One positive score was considered for the correct response and no score for the wrong answers. Cronbach alpha for this section was 0.84 and the range score was 0 to 9 that higher score indicated the more behavior. Intervention: After pretest and determining the students` educational weak and positive points, a curriculum was prepared regarding osteoporosis. Considering the time limitation and essential content, the curriculum was considered in form of two 60-minute training sessions. Training was carried out by the researcher and according to the interest of most students in form of lecture and question answer. The aim of the first session was increasing the knowledge level of the participants about the osteoporosis, identifying the danger factors, signs, complications, treatment and prevention, the role of nutrition in the prevention of this disease, and the importance of proper nutrition in the adolescents. At the end of the sessions, educational pamphlets and video (indirect teaching due to the lack of time for teaching all contents and reviewing them) was used to consolidate the learning. In the second session, physical activity and the importance of regular exercise for preventing osteoporosis, different type of sports, and appropriate activities for women was taught. In this session, lecture and question and answer methods were used (to change the attitude of the students). Since there was no possibility for long term follow-up because of the school summer holiday, intervention evaluation was done one month after the implementation. Statistical analysis Data was analyzed using SPSS software 19 version using independent t-test, paired t-test, and Pearson correlation for the quantitative variables and chi-square for the qualitative variables. Normality of distribution was confirmed using Kolmogorov-Smirnov test. The level of significance was considered 0.05 for all tests.
Findings by Text
In this study, 118 third grade junior high school girls in Kermanshah (53 in the interventional group and 65 in the control group) participated in this study. In table 1 the results of Chi-Square showed that there was no significant difference between the control and interventional group before the study between the control and interventional groups in terms of the most background and demographic variables (P>0.05). Only in the two variables of father education (P=0.002) and the osteoporosis family record (P=0.005) significant difference was observed between the two groups. Results showed that the mean of knowledge, attitude, and behavior in the domain of osteoporosis was not significant before the intervention in the two groups (p>0.05). After the intervention of the program, the knowledge (P-0.024), and attitude (P=0.003) was significantly different in the two groups. In terms of behavior, despite of increase in the mean score of interventional group, no significant difference was observed between the two groups (P=0.086) (table 2). In this study, no significant correlation was observed between any of demographic variables and the main variables of the study. However, the correlation between knowledge and attitude was significant (P=0.01; r=0.357).
Main comparison to the similar studies
… [20] Increase of knowledge in the students of the intervention group, was consistent with the results of Bohaty on the 80 19-30 year women in two west states of Omaha nursing school [21], as well as Kamjoo[22]and Nejati[23]. … [24-27]. Mohammed et al., also, showed that the attitude of female students regarding the prevention of osteoporosis after the implementing of curriculum was significantly different [28] … [29-33].
Suggestions
To affect the preventive behavior of osteoporosis, itis recommended to evaluate and compare the effect of theory-based intervention in this domain.
Limitations
Conducting the current study was accompanied with some limitations such as lacking enough time for measuring the sustainability impact of intervention and self-report questionnaire responses that present the probability of unrealistic responses.
Conclusions
Teaching in the domain of osteoporosis prevention increased the knowledge and attitude of adolescent female students in the Kermanshah but it did not lead to the behavior action.
Acknowledgments
Tarbiat Modarres University authorities, Kermanshah School Affairs Authorities, and all the students who participated in this study as well as Mr. Mehdi Mirza`IAlavicheh who cooperated in conducting this study are appreciated.
Conflict of interest
Non-declared
Ethical Permissions
Essential coordination was made with the Kermanshah Education Affair organization, school principals, teachers, and students and consent form was completed by the participants.
Funding Sources
This article is a part of research dissertation approved in Research Council of Medical School of Tarbiat Modarres University to obtain a master degree in health education.

TABLES and CHARTS

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