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The Relationship of Perceived Risk and Biases in Perceived Risk to Fracture Prevention Behavior in Older Women

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Annals of Behavioral Medicine



A bias in perceived risk for health outcomes, including fracture, exists.


We compared perceived risk and biases in perceived risk for fracture to fracture preventive behavior.


Women over age 55 (n = 2874) completed a survey five times over 5 years, and data was pulled from the medical record. Perceived risk was measured by asking women to rate their risk of fracture compared to similar women. Actual risk was measured using FRAX score. Bias was measured using an interaction between perceived and actual risk.


Higher perceived risk was related to lower quality of life and self-reported health, more medication and calcium use, increased bone density scan use, and less walking. Bias was only associated with less medication use. Neither perceived risk nor bias predicted medication adherence.


Perceived risk, but not bias, may predict different fracture prevention behaviors. Clinicians may need to base interventions on risk perceptions.

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The authors would like to thank the study participants and all the research staff who worked on this project. Drs. Jones, Gell, and Roth are supported by fellowships from the National Institute on Aging (T32 AG027677). Funding for this study was provided by The Alliance for Better Bone Health (Procter & Gamble Pharmaceuticals and Sanofi-Aventis) to The Center for Outcomes Research, University of Massachusetts Medical School.

Authors’ Statement of Conflict of Interest and Adherence to Ethical Standards

Drs. Scholes, Jones, Gell, and Roth do not have any conflict of interest to report. Dr. LaCroix serves on the advisory council of the GLOW study and has been supported by Sanofi-Aventis. All procedures, including the informed consent process, were conducted in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000.

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Correspondence to Salene M. W. Jones PhD.

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Jones, S.M.W., Gell, N.M., Roth, J.A. et al. The Relationship of Perceived Risk and Biases in Perceived Risk to Fracture Prevention Behavior in Older Women. ann. behav. med. 49, 696–703 (2015).

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