The proposed research will develop and test a """"""""decision support intervention"""""""" to aid women in becoming better decision makers concerning ERT as they cope with the experience of menopause. It is a competing continuation grant building on the results of the current research (NRO1245) studying """"""""Women's Judgments of Estrogen Replacement Therapy"""""""" (ERT). Women's use of information or """"""""policies"""""""" were assessed related to the likelihood of taking hormone replacement therapy (N=271). Cluster analysis was used to identify three major clusters of policies held by subgroups of women. The three groups differ widely in their use of risk information. Group 1 focused on hot flashes primarily, Group 2 on osteoporosis and hot flashes, and Group 3 focused on the potential negative side effects of therapy. Guided interviews of a subsample of women found that women understood the risk information provided, could articulate their use of information, and their descriptions were consistent with the statistical models. However, some women had difficulty translating population data to personal risk. A related study was done to assess nurses' policies and their counterparts reappeared suggesting the groups are stable. The findings suggest the intervention should explicitly help women incorporate their individual lifestyle priorities as well as understand risk information in reaching decisions about menopause, self-care, and ERT.. Using an experimental design, we will test the decision support intervention against written information only and lectures/discussion. Measures will be assessed at completion of the three week intervention, 6 months and one year post intervention. We will measure knowledge of menopause, satisfaction with decisions incorporated into a management plan, compliance with own plans, and satisfaction with provider's interaction. We hypothesize the decision support intervention will improve knowledge retention, satisfaction with personal decisions, compliance, and satisfaction with health care provider interaction. We will monitor but expect no change in perception of control, menopause as a problem, reported symptoms and management strategies. Findings from the study have implications for the class of health care problems requiring communication of risks and benefits.

Agency
National Institute of Health (NIH)
Institute
National Institute of Nursing Research (NINR)
Type
Research Project (R01)
Project #
5R01NR001245-06
Application #
3391190
Study Section
Nursing Research Study Section (NURS)
Project Start
1986-09-25
Project End
1994-07-31
Budget Start
1993-05-01
Budget End
1994-04-30
Support Year
6
Fiscal Year
1993
Total Cost
Indirect Cost
Name
Michigan State University
Department
Type
Schools of Nursing
DUNS #
193247145
City
East Lansing
State
MI
Country
United States
Zip Code
48824
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Holmes-Rovner, M; Kroll, J; Rovner, D R et al. (1999) Patient decision support intervention: increased consistency with decision analytic models. Med Care 37:270-84
Rothert, M L; Holmes-Rovner, M; Rovner, D et al. (1997) An educational intervention as decision support for menopausal women. Res Nurs Health 20:377-87
Holmes-Rovner, M; Padonu, G; Kroll, J et al. (1996) African-American women's attitudes and expectations of menopause. Am J Prev Med 12:420-3
Rothert, M; Rovner, D; Holmes, M et al. (1990) Women's use of information regarding hormone replacement therapy. Res Nurs Health 13:355-66