A Biopsychosocial Investigation of Women's Health at Midlife

描述（由申请人提供）：中年是女性个人生活和职业生涯发生重大变化的时期。此外，健康状况日益恶化，为晚年的生活质量奠定了基础。拟议研究的目的是确定和调查影响3个重要健康结果的纵向解释途径。我们的目标是常见的结果，并有很高的个人和社会成本：1)血管舒缩症状；2)抑郁症状；3)适应负荷。这项研究的一个显著特点是使用了一种创新的生物心理社会模型，该模型结合了妇女生活的多个领域，并承认妇女健康的多维性。具体而言，我们研究了社会压力源和社会支持的影响；2)心理因素；3)采用潜在增长曲线分析、纵向结构方程模型和纵向随机效应等方法，研究10年间不同健康状况下的生活方式行为。在此过程中，我们将确定这两个水平的具体途径，并随着时间的推移为每个妇女的每个健康结果进行改变。由于我们提出健康的多个方面以复杂的方式联系在一起，我们还将研究干预变量之间、健康结果之间的相互关系，并调查健康结果与干预变量之间可能的反馈。数据来自全国妇女研究（SWAN），这是一项以社区为基础的为期10年的中年妇女（基线年龄为42-52岁）纵向研究，旨在描述更年期过渡期间发生的生理和社会心理变化。通过强调可能改变的特征，拟议的研究将提供与临床和规划干预相关的新信息，这些干预可能有助于减少中年妇女的健康差异并促进她们的福祉。

DESCRIPTION (provided by applicant): Midlife is a time of significant change in women's personal and professional lives. Moreover, health increasingly deteriorates, setting the stage for quality of life in later years. The purpose of the proposed research is to identify and investigate the longitudinal explanatory pathways that impact 3 important health outcomes. We target outcomes that are common and that have high personal and social costs: 1) Vasomotor Symptoms; 2) Depressive Symptoms; and 3) Allostatic Load. A distinguishing feature of this research is its use of an innovative biopsychosocial model that incorporates multiple domains of women's lives and acknowledges the multidimensionality of women's health. Specifically, we investigate the impact of: 1) Social Stressors and Social Support; 2) Psychological Factors; and 3) Lifestyle Behaviors on each health condition over a 10-year period using latent growth curve analysis, longitudinal structural equation models, and longitudinal random effects, as appropriate. In so doing, we will identify the specific pathways for both level and change over time for each woman for each health outcome. Because we propose that multiple aspects of health are linked in complex ways, we will also examine the interrelationships between the intervening variables, between the health outcomes, and investigate possible feedback between health outcomes and intervening variables. Data are from the Study of Women Across the Nation (SWAN) a community-based, 10-year longitudinal study of midlife women (aged 42-52 at baseline) designed to characterize the physiological and psychosocial changes that occur during the menopause transition. By emphasizing characteristics that are potentially modifiable, the proposed research will provide new information relevant to clinical and programmatic intervention that may serve to reduce health differentials and promote well-being among midlife women. PUBLIC HEALTH RELEVANCE: Promoting health and well-being, especially as women enter into midlife and early old age is a key public heath priority. By better understanding how social, psychological, and lifestyle factors (many of which are modifiable) contribute to health during midlife, new information relevant to clinical and programmatic interventions will become available.