Poor Knowledge and Suboptimal Practice Regarding Postmenopausal Osteoporosis Prevention Among Chinese Postmenopausal Women: A Structural Equation Model Analysis.

BACKGROUND

This study aimed to investigate the knowledge, attitude, and practice (KAP) of postmenopausal women toward postmenopausal osteoporosis (PMOP).

METHODS

A cross-sectional study was conducted between March and July 2024 at the First Affiliated Hospital of Anhui Medical University among postmenopausal women, using a self-administered questionnaire. KAP scores ≥70% were defined as adequate levels based on previous literature. Structural equation modeling (SEM) was constructed based on the KAP theoretical framework to examine the relationships among knowledge, attitude, and practice.

RESULTS

A total of 466 valid questionnaires were analyzed, with a validity rate of 97.69%. The mean knowledge, attitude, and practice scores were 14.08 ± 7.90 (range: 0-30), 24.45 ± 2.43 (range: 7-35), and 16.42 ± 3.96 (range: 5-25), respectively. Multivariate logistic regression analysis revealed that knowledge was negatively associated with practice (OR = 0.936, 95% CI: [0.910-0.962], P < 0.001). Additionally, education level (OR = 1.752, 95% CI: [1.110-2.766], P = 0.016) and marital status (OR = 0.392, 95% CI: [0.167-0.917], P = 0.031) were independently associated with better practice. The structural equation model results indicated that knowledge was significantly associated with attitude (β = 0.481, 95% CI: 0.402-0.570, P = 0.009), and was negatively associated with practice (β = -0.324, 95% CI: -0.460-0.199, P = 0.011).

CONCLUSION

Postmenopausal women showed poor PMOP knowledge and prevention practices, with a notable knowledge-practice gap. Higher knowledge levels were associated with poorer preventive practices, suggesting that knowledge alone may not translate into appropriate health behaviors. Targeted interventions addressing both awareness and behavioral barriers are needed.