Knowledge, Attitudes, and Practices toward Osteoporosis: A Questionnaire Survey

Min Xue^1*Jiesheng Xia²Xiaohui You³Xun Zhu⁴Li Zheng⁴Qi Wei⁵Miao Zheng⁵Jialong Tao⁶Yuntian Shen⁷Qi Zhou⁸Jiani Qian⁹Minjie Chu¹⁰Youjia Xu^11*

• ¹Department of Ultrasound, The Second Affiliated Hospital of Soochow University, Suzhou, China
• ²Department of Ultrasound, Haimen People's Hospital, Nantong, China
• ³Center for Medical Ultrasound, Suzhou Municipal Hospital, The Affiliated Suzhou Hospital of Nanjing Medical University, Gusu School, Nanjing Medical University, Suzhou, China
• ⁴Department of Thyroid and Breast Surgery, The Second Affiliated Hospital of Soochow University, Suzhou, China
• ⁵The Osteoporosis Clinical Center, The Second Affiliated Hospital of Soochow University, Suzhou, China
• ⁶Department of Oncology, The Second Afffliated Hospital of Soochow University, Suzhou, China
• ⁷Department of Radiotherapy & Oncology, The Second Affiliated Hospital of Soochow University, Suzhou, China
• ⁸Functional Department of Changshu Fifth People's Hospital, Changshu, China
• ⁹Department of Pathology, The Second Affiliated Hospital of Soochow University, Suzhou, China
• ¹⁰Department of Epidemiology, School of Public Health, Nantong University, Nantong, China
• ¹¹Department of Orthopaedics, The Second Affiliated Hospital of Soochow University, Suzhou, China

Background: Osteoporosis is a prevalent yet often underdiagnosed condition that leads to significant morbidity and healthcare burdens. This study explores the knowledge, attitudes, and practices (KAP) of the community-dwelling adults concerning osteoporosis and its daily management. Methods: The cross-sectional study was conducted from June 1, 2024 to February 1, 2025 at the Second Affiliated Hospital of Soochow University and included outpatients aged 18 years and older. Demographic data and KAP scores were collected, and differences across demographic groups were analyzed. Structural equation modeling examined the relationships and mediation effects among knowledge, attitudes, and practices. Results: A total of 776 valid questionnaires were analyzed. Among the respondents, 458 (59.02%) were female, 376 (48.45%) had taken basic bone health supplements, and 100 (12.89%) had participated in osteoporosis education. The median age of the participants was 39 years (range: 18–76). The mean scores for knowledge, attitude, and practice were 14.66±9.06 (possible range: 0-38), 43.41±5.00 (possible range: 12-60), and 54.00±13.66 (possible range: 17-85), respectively. Significant positive correlations were found between knowledge and attitude (r = 0.434, P < 0.001), knowledge and practice (r = 0.441, P < 0.001), and attitude and practice (r = 0.463, P < 0.001). Structural equation modeling (SEM) results indicated that knowledge directly influenced attitude (β = 0.491, P = 0.023) and practice (β = 0.297, P = 0.020), while attitude directly influenced practice (β = 0.401, P = 0.009). Knowledge also indirectly affected practice through attitude (β = 0.197, P = 0.012). Conclusion: The study sample demonstrated insufficient knowledge, positive attitudes, and suboptimal primary osteoporosis prevention practices. Results indicated that knowledge directly influenced attitude and practice, while attitude directly influenced practice. Targeted educational interventions are crucial to enhance osteoporosis awareness and promote evidence-based preventive behaviors, ultimately improving bone health and reducing the risk of osteoporosis-related complications.