| Objective To understand the current status and influencing factors of osteoporosis knowledge, beliefs, and practices among elderly individuals with different levels of physical activity, and to analyze the differences in knowledge, beliefs, self-efficacy, and behavior among elderly individuals with different levels of physical activity. This study aims to provide a scientific basis for the prevention and treatment of osteoporosis based on the knowledge, beliefs, and practices model. Methods A total of 200 elderly urban residents in Jinan, Shandong Province, were selected as research subjects. The study used a short physical activity questionnaire, an osteoporosis knowledge, beliefs, and practices survey, and a bone health knowledge, beliefs, and practices influencing factors questionnaire to assess their physical activity levels, osteoporosis knowledge, beliefs, and practices, and influencing factors. Bone density was measured using an ultrasound bone densitometer. Data analysis was performed using SPSS version 19.0. Results Based on physical activity levels, participants were divided into high, medium, and low categories, accounting for 17.0%, 67.0%, and 16.0%, respectively. Among them, 44.0% had low bone mass or osteoporosis. The T-score, Z-score, and broadband ultrasound attenuation (BUA) of the medium physical activity group were significantly higher than those of the high and low physical activity groups (P<0.01). The Z-score of the high physical activity group was significantly higher than that of the low physical activity group (P<0.05). There were significant effects of physical activity level and bone health status on T-score and Z-score (P<0.01), while BUA showed a main effect of bone health status (P<0.01). In terms of knowledge, beliefs, and self-efficacy, the high physical activity group scored significantly higher than the medium and low physical activity groups (P<0.05, P<0.01). The medium physical activity group had significantly higher self-efficacy than the low physical activity group (P<0.01). The self-efficacy of the osteoporosis group and normal bone group was significantly higher than that of the low bone mass group (P<0.05, P<0.01). Physical activity level had a main effect on knowledge and behavior (P<0.01), while belief showed an interaction effect between physical activity level and bone health status (P<0.05). Belief also showed a main effect of bone health status (P<0.05). Education level, pre-retirement occupation, family history of osteoporosis, exercise intensity, and average monthly income were important factors affecting the knowledge, beliefs, and practices of elderly individuals with different levels of physical activity. Conclusion There is a positive correlation between physical activity levels and bone density with osteoporosis knowledge, beliefs, and practices scores among the elderly. Higher awareness of bone health leads to a tendency towards more active exercise, which helps increase bone density. |