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Effect of Osteoporosis Screening Education on Osteoporosis Screening Awareness among Postmenopausal Women in Nigeria

Abstract

Osteoporosis is an important women's health concern characterized by reduced bone strength and increased susceptibility to fractures. The risk of osteoporosis generally increases with age, particularly after menopause, when reduced oestrogen levels contribute to accelerated bone loss. Postmenopausal women may also face additional risk factors such as inadequate calcium and vitamin D intake, physical inactivity, low body weight, family history, smoking, excessive alcohol consumption, and prolonged use of certain medications. Despite the importance of early identification, awareness of osteoporosis screening among postmenopausal women in Nigeria may be limited because of inadequate health education, misconceptions, low perceived susceptibility, financial constraints, limited access to screening services, and competing healthcare priorities. Osteoporosis screening education provides an opportunity to improve women's understanding of osteoporosis risk, available screening options, eligibility considerations, and the importance of early assessment. Against this background, this study investigates the effect of osteoporosis screening education on osteoporosis screening awareness among postmenopausal women in Nigeria. The study will be anchored on the Health Belief Model, Social Cognitive Theory, and Health Promotion Model. The Health Belief Model explains how women's perceptions of their susceptibility to osteoporosis, perceived severity of fractures and related complications, perceived benefits of screening, perceived barriers, and cues to action may influence their awareness and willingness to seek osteoporosis screening. Social Cognitive Theory emphasizes knowledge acquisition, self-efficacy, observational learning, social support, and environmental influences in developing health-related behaviours. The Health Promotion Model emphasizes individual experiences, perceived benefits and barriers, interpersonal influences, and behavioural factors that influence participation in preventive healthcare activities. Collectively, these theoretical perspectives provide a suitable framework for explaining how osteoporosis screening education may influence osteoporosis screening awareness among postmenopausal women in Nigeria. The study will adopt a quantitative analytical cross-sectional or quasi-experimental research design. The study population will comprise postmenopausal women attending selected hospitals, primary healthcare centres, women's health clinics, community health programmes, and other relevant healthcare or community settings across Nigeria. A multistage sampling technique will be used to select states, local government areas, communities, healthcare facilities, organizations, and eligible women. Osteoporosis screening education will be assessed using indicators such as exposure to structured screening education, frequency and duration of educational sessions, information on osteoporosis risk factors, consequences of osteoporosis, postmenopausal bone loss, eligibility for screening based on applicable clinical guidance, available screening approaches, the purpose of bone mineral density assessment, screening locations, potential benefits and limitations of screening, and appropriate healthcare-seeking. Osteoporosis screening awareness will be assessed using indicators such as recognition of osteoporosis as a postmenopausal health concern, knowledge of risk factors, awareness of screening importance, awareness of appropriate screening services, understanding of when professional assessment may be recommended, knowledge of available screening facilities, and awareness of the relationship between early assessment and fracture prevention. Data will be collected using structured questionnaires and appropriate osteoporosis knowledge or screening-awareness assessment instruments where available. Descriptive statistics will be used to summarize participants' characteristics, exposure to osteoporosis screening education, and levels of screening awareness. Inferential statistical techniques, including chi-square tests, t-tests, correlation analysis, and logistic or multiple regression analysis where appropriate, will be used to determine the effect of osteoporosis screening education on osteoporosis screening awareness. Where a quasi-experimental design is adopted, screening-awareness scores before and after structured education may be compared, while relevant age, duration since menopause, educational, socioeconomic, health, lifestyle, and healthcare-access factors are appropriately controlled. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that osteoporosis screening education has a significant positive effect on osteoporosis screening awareness among postmenopausal women in Nigeria. Women who receive structured and evidence-based screening education are expected to demonstrate greater awareness of osteoporosis risk factors, the importance of screening, appropriate screening options, and available healthcare services than women with limited exposure to osteoporosis information. Education may correct misconceptions, increase perceived susceptibility to osteoporosis, improve understanding of postmenopausal bone loss, and encourage women to discuss their bone health and screening needs with qualified healthcare providers. Increased awareness may also encourage appropriate preventive practices and timely assessment among women who meet relevant clinical criteria for screening. However, financial barriers, limited availability of screening facilities, geographical constraints, low health literacy, cultural beliefs, competing health priorities, and inadequate access to healthcare professionals may limit the translation of awareness into screening utilization. The study therefore expects accessible, culturally appropriate, evidence-based, and regularly reinforced osteoporosis screening education to contribute significantly to improved screening awareness among postmenopausal women in Nigeria. The study is expected to contribute to the literature on osteoporosis screening education, osteoporosis screening awareness, postmenopausal women's health, bone health, osteoporosis prevention, healthy ageing, fracture prevention, preventive healthcare, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Primary Health Care Development Agency, state ministries of health, hospitals, primary healthcare centres, women's health clinics, healthcare providers, community health workers, development partners, and policymakers regarding strategies for improving awareness of osteoporosis screening. The study will also provide evidence-based recommendations for integrating osteoporosis screening education into appropriate women's health and primary healthcare services, training healthcare workers in bone health and screening communication, developing culturally appropriate educational materials, improving referral pathways for women who may benefit from assessment, strengthening community-based bone health programmes, and promoting informed discussion of osteoporosis screening among postmenopausal women across Nigeria.

Keywords: Osteoporosis screening education, osteoporosis screening awareness, postmenopausal women, osteoporosis, bone health, screening awareness, fracture prevention, healthy ageing, women's health, preventive healthcare, Nigeria, public health.