This research develops the Osteoporosis Knowledge, Attitude and Behaviors Questionnaire (OKABQ) with the intent to evaluate the levels of osteoporosis knowledge, attitude and behavior change by developing and validating the OKABQ while establishing a mediation model of the research. A quantitative, descriptive and instrumental study was conducted in two phases: Phase I-development of the scale through Delphi Method by osteoporosis experts; and Phase II-evaluation of the validity and reliability of the scale and construction of a mediation model using SmartPLS. In Phase I, the content validity index (CVI) of the questionnaire was higher than 0.96 and the inter-rater reliability (IRR) kappa was 1.00. In Phase II, exploratory factor analysis showed that two predominating factors of attitude as a mediation were addressed by the 26-item OKABQ. The indirect effect results from the estimated model indicate that attitude mediates the relationship between knowledge and behaviors (β = 0.114, t = 2.627, p < 0.001), which is positive and statistically significant. We concluded that the OKABQ is a valid measure of osteoporosis knowledge, attitudes and behaviors for women with osteoporosis. These assessment results could assist healthcare providers in mitigating insufficiency in health education and help patients better adapt to a more active bone-healthy lifestyle.
Keywords: attitude; behaviors; osteoporosis; osteoporosis education; questionnaire development.