Empirical Testing

Intervention Study: Osteoporosis

Issue: Women under 65 are not screened often for bone density

Population: Women in the U.S. between 50-60 years of age

Methods: A convenience sample of N= 203 women, between 50-65 years of age, with no prior bone density test were surveyed at baseline, 6, and 12 months. This was a experimental longitudinal study design, where the treatment group was scheduled for a free Bone Mineral Density (BMD) exam after completing the initial assessment, and the control group was offered a free BMD exam after the 12 month assessment. Changes in knowledge, self-efficacy, and health beliefs were assessed by group assignment. Results: At follow-up, women in the treatment group scored significantly higher on the perceived susceptibility score, calcium intake, and use of preventive medication.

Conclusion: Personal knowledge gained from bone mineral density exams increased health beliefs about susceptibility to osteoporosis and prevention behaviors.


(Osteoporosis Health Belief Scale)

(5 point scale ranging from "strongly disagree" to "strongly agree")
Perceived Susceptibility You are more likely than the average person to get osteoporosis.
Perceived Severity It would be very serious if you got osteoporosis.
Perceived Benefits-calcium Taking in enough calcium prevents problems from osteoporosis.
Perceived Barriers-calcium Eating calcium-rich foods requires changing your diet, which is hard to do.

Source: C.A., Doheny M.O., Estok P.J., Zeller R.A., Winchell J. (2007). DXA, health beliefs, and osteoporosis prevention behaviors. Journal of Aging and Health,19(5),742-56.

Non-Intervention Study: Cervical Cancer Screening

Issue: Hispanic women in the U.S. have low rates of participation in cervical cancer screening programs, compared to women of other ethnic groups.

Population: Hispanic women ages 18-25 living in El Paso, Texas

Methods: A convenience sample of N= 189 women were given an interviewer-administered survey to generate an understanding about women's beliefs about cervical exams. Four HBM constructs were used to assess associations with the primary outcome, "prior history of Pap exams."

Results: Fifty-six percent reported having a pap test in the past year. Several significant associations were found for "perceived barriers" and "never having a pap test," including that the Pap test would impair virginity, or be painful or embarrassing. None of the perceived severity, susceptibility and perceived benefits items were associated with ever having a Pap test.

Conclusions: Perceived barriers were a strong predictor of never having a Pap test.


(4 point scale ranging from "strongly agree" to "strongly disagree")
Perceived Susceptibility (3 items) Young women are at risk for cervical cancer.
Perceived Severity (4 items) Cervical cancer is easily cured.
PPerceived Benefits ( 3 items) If cervical changes are found early, they are easily curable.
Perceived Barriers (10 items) It is too embarrassing to have a Pap test

Source: Byrd T.l., Peterson S.K., Chavez R., Heckert A. (2004). Cervical cancer screening beliefs among young Hispanic women. Preventive Medicine, 38,192-197