ORIGINAL ARTICLE Awareness of osteoporosis among female head of household: an Iranian experience Pouria Khashayar 1 & Mostafa Qorbani 2,3 & Abbasali Keshtkar 4 & Patricia Khashayar 5,6 & Amir Ziaee 7 & Bagher Larijani 8 Received: 4 November 2016 /Accepted: 27 March 2017 /Published online: 6 April 2017 # International Osteoporosis Foundation and National Osteoporosis Foundation 2017 Abstract Summary More than 81% of the studied women had a poor knowledge of different aspects of osteoporosis and its compli- cations, suggesting that more educational programs targeting women in particular are needed to help improve the osteopo- rosis practice in the societies and reduce the burden of the disease. Purpose The family structure has changed considerably in the past decade. But, women from Iran and many countries in the region and even families with similar cultural background living in other parts of the world are still responsible for childcare as well as the lifestyle adapted by the family. The present study was conducted to assess the awareness of the female head of household of osteoporosis and its complications. Methods As part of a population-based study in two Iranian cities, Arak and Sannandaj, to study osteoporosis and its risk factors, a questionnaire on the knowledge of female head of households of osteoporosis and its complications was com- pleted. The subsample filled out the knowledge survey along with the questionnaire on their demographic data, socioeco- nomic status (SES), reproductive factors, bone-related life- style habits, family and personal medical history, medication use, and compliance with osteoporosis medication (if used) as well as a FFQ filled out for all the 2100 participants. They also underwent a bone mineral density (BMD) test, and their serum levels of vitamin D were calculated. These data were then used to assess the factors affecting their awareness level. Results The knowledge of 81.3% (473) of the studied women was found to be poor on different aspects of osteoporosis and its complications. Multivariate analysis revealed that each lev- el increase in vit D intake tertile increases the chance of higher awareness level in K-Total by 1.5 times. Each level increase in physical activity tertile was associated with a 30.6% lower chance of having a good knowledge. Conclusion Considering the poor awareness level of the stud- ied women and their poor practice of bone healthy behavior, one could conclude that more programs are needed or the content/delivery style of the existing ones should be optimized. Electronic supplementary material The online version of this article (doi:10.1007/s11657-017-0330-7) contains supplementary material, which is available to authorized users. * Bagher Larijani larijanib@tums.ac.ir 1 Faculty of Medicine, Qazvin University of Medical Sciences, Tehran, Iran 2 Department of Community Medicine, Alborz University of Medical Sciences, Karaj, Iran 3 Department of Epidemiology and Biostatistics, Iran University of Medical Sciences, Tehran, Iran 4 Department of Health Sciences Education Development, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran 5 Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran 6 Center for Microsystems Technology, Imec and Ghent University, Zwijnaarde, Ghent, Belgium 7 Growth and Development Research Center, Iran University of Medical Sciences, Tehran, Iran 8 Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran Arch Osteoporos (2017) 12: 36 DOI 10.1007/s11657-017-0330-7