Program Director/Principal Investigator (Last, First, Middle): SantOrO, Nanette PROJECT SUMMARY (See instructions): SWAN, the Study of Women's Health Across the Nation, is a multi-ethnic, multi-site study of mid life women in the United States that has been active for over 10 years. The SWAN-New Jersey cohort had the lowest socio-economic status, the poorest health indicators at baseline and has suffered from substantialloss to follow up and impediments to continued research. Despite substantial attrition, SWAN-New Jersey Hispanic women continue to have the highest rate of incident metabolic syndrome and type 2 diabetes, and report more symptoms with more adverse reactions to their symptoms over the menopause transition compared to the rest of the SWAN cohort. We have also recognized the need to better understand key discrepancies between our data on Hispanic women and the rest of the cohort with respect to the use of complementary and alternativemedicineand the reporting of total daily caloric intake. We thus propose 3 specific aims that will focus exclusively on the remaining Hispanic cohort members (n=150) and seek to integrate quantitative and qualitative methods of inquiriy:
Aim 1 will continue to collect quantitative data;physical measurements, blood and abbreviated survey data and SCID interviewson our Hispanic cohort members to address as may overall SWAN FVhypotheses as are feasible and to test specificallythe hypothesies that Hispanic women will be more likely to: a. acquire metabolic syndrome and diabetes;b. report more vasomotor symptoms and experience greater distress from them yet seek medical treatment less frequently than other ethnic groups in SWAN .
Aim 2 will examine discrepancies between the Hispaniccohort and the rest of SWAN to test the hypotheses that Hispanic women: a. do not view menopause as a medical conditionthat requires treatment;b. utlize more CAM treatment than believed due to lack of ethnically appropriate survey use and c. under-reported calories consumed due to a lack of ethnically appropriate food choices on the surveys used.
Aim 3 will explore attitudesand benefits associated with menopause, investigate the conceptual perspective through which women experience menopausal symptoms, and investigate and examine what coping mechanisms and practices are utilized such as CAM and diet through the use of narrative interviews (qualitative research) with Hispanic women.

Public Health Relevance

fSee instructions): The combination of quantitative and qualitative approaches is intended to maximize the information that can be obtained from a difficult-to-recruit and retain population of women for whom retention has been a challenge, and will serve to inform future research dedicated to study of a mixed group of Hispanic women. These findings can be applied to the challenges involved in conducting clinical research in ethnic minorities. PROJECT/

National Institute of Health (NIH)
National Institute on Aging (NIA)
Research Project--Cooperative Agreements (U01)
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Special Emphasis Panel (ZAG1-ZIJ-8 (J3))
Program Officer
Rossi, Winifred K
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Albert Einstein College of Medicine
Obstetrics & Gynecology
Schools of Medicine
United States
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Santoro, Nanette; Crawford, Sybil L; El Khoudary, Samar R et al. (2017) Menstrual Cycle Hormone Changes in Women Traversing Menopause: Study of Women's Health Across the Nation. J Clin Endocrinol Metab 102:2218-2229
Putman, Melissa S; Yu, Elaine W; Lin, David et al. (2017) Differences in Trabecular Microstructure Between Black and White Women Assessed by Individual Trabecular Segmentation Analysis of HR-pQCT Images. J Bone Miner Res 32:1100-1108
Wu, Xiangmei May; Basu, Rupa; Malig, Brian et al. (2017) Association between gaseous air pollutants and inflammatory, hemostatic and lipid markers in a cohort of midlife women. Environ Int 107:131-139
El Khoudary, Samar R; Shields, Kelly J; Janssen, Imke et al. (2017) Postmenopausal Women With Greater Paracardial Fat Have More Coronary Artery Calcification Than Premenopausal Women: The Study of Women's Health Across the Nation (SWAN) Cardiovascular Fat Ancillary Study. J Am Heart Assoc 6:
Karlamangla, Arun S; Lachman, Margie E; Han, WeiJuan et al. (2017) Evidence for Cognitive Aging in Midlife Women: Study of Women's Health Across the Nation. PLoS One 12:e0169008
Bromberger, Joyce T; Schott, Laura L; Matthews, Karen A et al. (2017) Childhood socioeconomic circumstances and depressive symptom burden across 15 years of follow-up during midlife: Study of Women's Health Across the Nation (SWAN). Arch Womens Ment Health 20:495-504
Appelhans, Bradley M; Baylin, Ana; Huang, Mei-Hua et al. (2017) Beverage Intake and Metabolic Syndrome Risk Over 14 Years: The Study of Women's Health Across the Nation. J Acad Nutr Diet 117:554-562
Paramsothy, Pangaja; Harlow, Siobán D; Nan, Bin et al. (2017) Duration of the menopausal transition is longer in women with young age at onset: the multiethnic Study of Women's Health Across the Nation. Menopause 24:142-149
Kravitz, Howard M; Janssen, Imke; Bromberger, Joyce T et al. (2017) Sleep Trajectories Before and After the Final Menstrual Period in The Study of Women's Health Across the Nation (SWAN). Curr Sleep Med Rep 3:235-250
Kim, Catherine; Harlow, Siobàn D; Zheng, Huiyong et al. (2017) Changes in androstenedione, dehydroepiandrosterone, testosterone, estradiol, and estrone over the menopausal transition. Womens Midlife Health 3:

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