This thesis makes recommendations for the design of future osteoporosis prevention education for young adults through the investigation of the relationship between nutrition knowledge and perceived osteoporosis risk. Osteoporosis is a significant public health issue in Canada and nutrition represents an important component of current osteoporosis prevention education. Most osteoporosis prevention is designed for older adults, excluding young adults who are making decisions that will affect their future disease risk. Designing osteoporosis prevention for young adults means creating tailored prevention programs for young adults. Using a mixed method approach that involved a survey, food frequency questionnaire (FFQ), qualitative interviews, and a pile sort activity, I explored how the interactions between perceptions of nutrition and health, dietary practices, and constructions of disease risk affected participation in osteoporosis prevention behaviors in sixty Canadian young adults (17-30 years). Three research questions represented the core of this investigation: How do perceptions of dietary intake of calcium and vitamin D compare to measured intake? How do perceptions of osteoporosis risk contribute to preventative dietary behaviors? Where and how do young adults acquire knowledge about bone health and nutrition and how can this be used to inform the design of prevention programs? These questions are addressed in this ‘sandwich’ thesis in three papers that have been submitted for publication.
Canadian young adults have been identified as having low dietary intake of calcium and vitamin D, which are essential nutrients for maintaining bone health. Understanding calcium and vitamin D consumption practices is therefore necessary to create targeted messaging that will result in greater intake of these nutrients. The majority of participants were found to perceive their intake of calcium and vitamin D to be adequate, when in fact they were estimated through the FFQ to be consuming inadequate amounts of both nutrients. Participants explained their perceptions of their diet as adequate due to their belief that their diet was healthy, the perceived absence of any nutrition-related symptoms, and the belief that calcium and vitamin D were present in many foods in their diet. Addressing these assumptions and encouraging young adults to question their intake is necessary in engaging them with prevention education and modifying dietary behaviors.
Osteoporosis risk is heavily gendered in contemporary prevention programs that primarily target women. This differential focus creates disparities in how risk is understood in terms of perceived susceptibility, severity, and individuals’ self-efficacy in undertaking prevention behaviors. The use of the Health Belief Model as a framework to investigate these perceptions of risk revealed that while neither gender was motivated to engage in osteoporosis prevention, beliefs about individual risk of disease were a negotiation between larger gender constructs of osteoporosis and a variety of risk factors. The design of new prevention programs needs to address these differential understandings of risk and create targeted education plans for men and women.
This study shows that designing prevention programs means adopting effective knowledge translation methods that recognize the sources of information that young adults rely on and their nutrition- and health-related interests. Making use of traditional (e.g., parents, doctors) and emerging (e.g., social media) sources, while creating messaging that is short, relatable and linked to current interests will help create prevention programs that engage young adults and motivate them to participate in prevention. The increasing incidence of osteoporosis signals a need for expanded prevention programs that move beyond the current at-risk population. To be effective these new programs need to address both the nutrition beliefs of young adults and the perceptions of disease risk in order to holistically address the barriers to engagement with prevention information experienced by this age group. / Thesis / Doctor of Philosophy (PhD)
| Identifer | oai:union.ndltd.org:mcmaster.ca/oai:macsphere.mcmaster.ca:11375/20442 |
| Date | January 2016 |
| Creators | Holland, Alyson |
| Contributors | Moffat, Tina, Anthropology |
| Source Sets | McMaster University |
| Language | English |
| Detected Language | English |
| Type | Thesis |
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