Electronic Theses and Dissertations

Date of Award


Document Type


Degree Name

Ph.D. in Health and Kinesiology


Health, Exercise Science, and Recreation Management

First Advisor

Allison Ford-Wade

Second Advisor

Melinda Valliant

Third Advisor

Scott Owens

Relational Format



It is expected that by 2030, elderly minorities will comprise 20.2 million of the total 72.8 million population of Americans over 65 years (pollard, 2013). For African American women over the age of 50, 5% have osteoporosis and an estimated 35% have low bone mass (nof, n.d.). It is estimated that while over 40% of African American women over 80 years meet criteria for treatment, yet less than 12% are actually treated (Cauley, 2011). Striking disparities exist between African American and Caucasian women's likelihood for dual-energy x-ray absorptiometry (dxa) referral, the measurement tool that is used to diagnosis osteoporosis. (Hamrick, cao, Agbafe-Mosley & Cummings, 2012; Miller et al., 2005; Wanko, 2003). When African American females suffer a hip fracture, they show a higher morbidity and mortality rate when compared to their Caucasian counterparts (Geller & Derman, 2001; Kidambi, Partington, & Binkley, 2005; nof, 2014). A disproportionate number of African Americans are limited in their physical and mental abilities after a fracture compared to Caucasian patients (Bohannon, 1999; Geller & Derman, 2005; Furstenberg & Mezey, 1987). African American women are twice more likely to die from a hip fracture than Caucasian women within the first year of the fall (Geller & Derman, 2001). Interventions are needed to identify health care provider biases regarding osteoporosis screening (Neuner, J., Zhang, X., Sparapani, R., Laud, P. & Nattinger, A., 2007). Many, including African Americans, perceive only Caucasians to be susceptible to the disease (Geller & Derman, 2001; nof, 2013). Further, the national osteoporosis foundation (nof) found the average age for discussion initiation between mothers and daughters about osteoporosis does not occur until after peak bone mass is reached (2011). Purpose: this research project aimed to investigate the relationship between osteoporosis knowledge, bone mineral density (bmd), risk factors of low bmd, and preventative behaviors among African American and Caucasian mothers and their biological adolescent daughters. Additionally, this study seeks to explore whether mothers and daughter discuss osteoporosis preventative behaviors. Methods: thirty-seven pairs of African American and Caucasian mothers and their 13-18 year old biological daughters participated in this study. Femoral and spinal bmd using dxa were obtained. Participants also completed the osteoporosis risk factor assessment (orfa), osteoporosis knowledge test (okt), health communication survey and an online calcium quiz to measure preventative behaviors, knowledge, calcium intake, and osteoporosis discussion engagement. Results: over a third (33%) of African American and 26% of Caucasian mothers in this study had osteopenic bmd at the hip and spine. African American mothers and daughters had lower overall spinal and hip bone density compared to their Caucasian counterparts. Body fat and bmi among African American and Caucasians were significantly different. There were no significant differences in mean spinal or femoral bmd based on the predictor variables. Independent t-tests for significant differences in each observed mother-daughter pair between races was measures and compared across bmd, calcium intake and physical activity. Paired samples test indicated significant differences between African American and Caucasian mother-daughter pairs at the l-4 of the lumbar spine (p<0.05), but not for any other bone density measurement. A small percentage of mothers and daughters were aware of their calcium recommended daily allowance (rda). Conclusions: future research should continue to investigate premenopausal African American mothers and daughters, possibly expanding to include a third generation of relatives. Preventative health programs should begin before peak bmd occurs and be racially inclusive.


Emphasis: Health Behavior



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