Knowledge-behavior disparities in osteoporosis prevention among postmenopausal women: evidence from Armenia

This study assessed osteoporosis knowledge and preventive practices among postmenopausal women in Armenia. A substantial knowledge deficit was identified despite moderate preventive behaviors. Education and self-rated health influenced outcomes, highlighting the need for targeted educational interventions and strengthened physician involvement.

Osteoporosis is a major global public health problem, particularly among postmenopausal women, due to its asymptomatic course and high risk of fragility fractures. Despite advances in diagnosis and treatment, insufficient awareness and suboptimal preventive practices remain significant challenges.

To assess osteoporosis-related knowledge and preventive practices among postmenopausal women in Armenia and to examine the association between knowledge and engagement in preventive behaviors.

A cross-sectional study was conducted among 442 women aged 45-75 years in Yerevan, Armenia. Participants without a prior diagnosis of osteoporosis were recruited using convenience sampling. Data were collected using a structured questionnaire, including the Osteoporosis Knowledge Assessment Tool (OKAT) and measures of preventive practices (physical activity, calcium and vitamin D intake, and bone mineral density screening). Preventive practices were summarized using a composite score (0-5). Logistic regression analyses were performed. Two outcomes were analyzed by binary logistic regression-osteoporosis knowledge (low vs moderаte/high) and preventive practice (low vs moderаte/high). Univariate models screened socio-demographic, lifestyle and medical predictors of each outcome. A multivariate logistic model with simultaneous entry of all candidate predictors then identified independent predictors of preventive practice.

Most participants (76.9%) demonstrated low osteoporosis-related knowledge, with a mean OKAT score of 6.6 ± 3.7 out of 20. Preventive practices were predominantly moderate (56.3%), with a mean score of 2.7 ± 1.2 out of 5. Adequate vitamin D intake was observed in 84.6% of participants, whereas adequate calcium intake was observed in only 39.1% of participants and only 27.8% had ever undergone bone mineral density screening. Higher education was associated with better knowledge (OR = 2.56; p = 0.008). In a multivariate model with all candidate predictors entered simultaneously, a positive self-rated health status (adjusted OR = 2.15; p = 0.017) and greater knowledge (adjusted OR = 1.70; p = 0.035) were independently associated with engagement in preventive practice.

A substantial deficit in osteoporosis-related knowledge exists among postmenopausal women in Armenia despite moderate preventive practices. Targeted educational strategies are needed.