Bone Abstracts

Purpose: This combined qualitative and quantitative study aimed to investigate women’s personal reasons for and choices to decline the screening for osteoporosis. The ROSE study is a randomized prospective population-based trial investigating the efficacy of a screening program to prevent fractures in women aged 65–80 years.

Methods: A triangulated approach combining data from interviews and questionnaire. 7020 questionnaires from the screening group in the ROSE-study were included. In total 205 telephone interviews and five in-depth interviews were carried out. Principles from critical psychology guided the analysis of the qualitative data.

Results: Women reasoned their choice on declining screening by three themes: Not at risk – embodied knowledge, osteoporosis – a minor health concern, and consequences and harms of screening. Age, bodily comprehension of risk, experience of osteoporosis, health-seeking behavior in daily life was important to the women’s decision on declining screening. Data from the questionnaire showed that a majority of women who declined screening significantly perceived themselves at low risk for fracture, were older and had less risk factors compared to participating women. Perceived low risk was found to be the main reason for cancelling DXA appointment. Furthermore, issues on co-morbidity distance to the DXA-scan, immobility, concerns about side-effect to treatment and to be labeled were important to the women.

Conclusion: Women, who declined screening, were older, perceived own fracture risk lower than their peers, and reported a lower proportion of risk factors. Furthermore, the interviews unfolded that some women decline screening due to co-morbidity and immobility or long distance to DXA. Women’s choices in relation to participating in screening or not, are interpreted by perceived susceptibility and severity of osteoporosis, and benefits or harms of participating in the screening program. Knowledge on these issues is important to the effectiveness of the screening programs, the management of osteoporosis and informed decisions making.