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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Study Section
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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Yoshida, Kazuki; Yu, Zhi; Greendale, Gail A et al. (2018) Effects of analgesics on bone mineral density: A longitudinal analysis of the prospective SWAN cohort with three-group matching weights. Pharmacoepidemiol Drug Saf 27:182-190
Waetjen, L Elaine; Xing, Guibo; Johnson, Wesley O et al. (2018) Factors associated with reasons incontinent midlife women report for not seeking urinary incontinence treatment over 9 years across the menopausal transition. Menopause 25:29-37
Allshouse, Amanda A; Santoro, Nanette; Green, Robin et al. (2018) Religiosity and faith in relation to time to metabolic syndrome for Hispanic women in a multiethnic cohort of women-Findings from the Study of Women's Health Across the Nation (SWAN). Maturitas 112:18-23
Allshouse, Amanda; Pavlovic, Jelena; Santoro, Nanette (2018) Menstrual Cycle Hormone Changes Associated with Reproductive Aging and How They May Relate to Symptoms. Obstet Gynecol Clin North Am 45:613-628
Hanley, Carrie; Shields, Kelly J; Matthews, Karen A et al. (2018) Associations of cardiovascular fat radiodensity and vascular calcification in midlife women: The SWAN cardiovascular fat ancillary study. Atherosclerosis 279:114-121
Chyu, Laura; Upchurch, Dawn M (2018) A Longitudinal Analysis of Allostatic Load among a Multi-Ethnic Sample of Midlife Women: Findings from the Study of Women's Health Across the Nation. Womens Health Issues 28:258-266
Delamater, Lara; Santoro, Nanette (2018) Management of the Perimenopause. Clin Obstet Gynecol 61:419-432
Avis, Nancy E; Crawford, Sybil L; Green, Robin (2018) Vasomotor Symptoms Across the Menopause Transition: Differences Among Women. Obstet Gynecol Clin North Am 45:629-640
Hanley, Carrie; Matthews, Karen A; Brooks, Maria M et al. (2018) Cardiovascular fat in women at midlife: effects of race, overall adiposity, and central adiposity. The SWAN Cardiovascular Fat Study. Menopause 25:38-45
Chung, Hsin-Fang; Pandeya, Nirmala; Dobson, Annette J et al. (2018) The role of sleep difficulties in the vasomotor menopausal symptoms and depressed mood relationships: an international pooled analysis of eight studies in the InterLACE consortium. Psychol Med 48:2550-2561

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