CAM Use in Midlife Women in Five Ethnic Groups

说明(申请人提供)：妇女一般是医疗保健的主要消费者，特别是补充和替代医学(CAM)的主要消费者。1999年，美国女性在更年期的CAM疗法上花费了超过6亿美元。关于更年期使用CAM的流行率、选择CAM与传统疗法治疗绝经的中年妇女的特征，以及种族/民族群体使用CAM的类型和流行率以及更年期状态的变化，人们知之甚少。在过去的10年里，用于更年期管理的CAM的市场和使用大幅增加，但关于妇女对CAM的选择如何影响更年期期间传统保健的使用，人们知之甚少。到2025年，美国绝经后妇女的数量将是20世纪90年代中期的两倍。在绝经过渡期间，妇女在选择传统激素疗法和/或CAM使用方面的选择发生了变化，这些选择的结果自过去一年WHI宣布以来变得越来越重要。因此，女性可能会求助于CAM，但这些治疗方法的研究较少，也不一定没有不良影响。 本申请建议通过对全国妇女健康纵向研究(SWAN)和2002年全国健康访谈调查(NHIS)的CAM补编中包括的3300名中年妇女进行年度06次后续访问，对收集的数据进行基线分析。本申请的具体目的是：1)检查影响开始和继续使用CAM的人口、生活方式和医学因素的纵向种族/族裔差异；2)确定妇女在中年使用特定类型的CAM的问题的类型，以及这些问题是否因种族/民族的不同而不同，以及这些问题是否随更年期状况的变化而纵向变化；以及3)将天鹅中年妇女队列中使用CAM的类型和原因与接受2002年NHIS补充CAM问卷调查的同龄和种族/族裔群体的妇女进行比较。 这些目标将通过对从基线到第六次年度后续访问在SWAN队列中收集的现有数据进行二级数据分析，并将SWAN数据与2002年NHIS CAM用于第三个目标的数据进行比较来实现。我们的假说源于对天鹅中年女性队列中使用CAM的早期数据的初步检查。目前的分析结果将对了解中年妇女使用CAM的普遍程度，以及影响该年龄组使用CAM的因素和原因，以及这些原因、决定因素和使用CAM的类型如何随种族/民族和更年期过渡而变化，将做出有价值的贡献。

DESCRIPTION (provided by applicant): Women are the primary consumers of health care in general and of complementary and alternative medicine (CAM) in particular. In 1999, women in the United States spent more than $600 million for CAM therapies for menopause. Little is known about the prevalence of CAM use during menopause, characteristics of midlife women who choose CAM versus conventional therapies for menopause, and differences in types and prevalence of CAM use by racial/ethnic groups and with changes in menopausal status. Marketing and use of CAM for menopause management has increased dramatically in the past 10 years, yet very little is known about how women's choices about CAM may affect use of conventional health care during menopause. By the year 2025, the number of postmenopausal women in the United States will double that of the mid-1990s Changes in women's choices in selecting conventional hormone therapy and/or CAM use across the menopausal transition and the outcomes of these choices are topics that have taken on increased importance since the WHI announcements over the past year. Women may turn to CAM as a result, but these remedies are less well-studied and not necessarily free of adverse effects. The present application proposes to undertake analyses of data collected baseline through the annual 06 follow-up visit in the multi-ethnic cohort of 3300 midlife women included in the longitudinal Study of Women's Health Across the Nation (SWAN) and the CAM Supplement to the 2002 National Health Interview Survey (NHIS). The specific aims of the present application are: 1) To examine longitudinally racial/ethnic differences in and the demographic, lifestyle and medical factors that affect initiation and continuation of CAM use; 2) To determine the types of problems for which women use specific types of CAM in midlife and whether these differ by race/ethnicity and change longitudinally with changes in menopausal status; and 3) To compare the types of and reasons for CAM use in the SWAN cohort of midlife women, to those in women of similar age and racial/ethnic groups who were administered the 2002 NHIS supplemental CAM questionnaire. These aims will be achieved through secondary data analyses of existing data collected in the SWAN cohort from baseline through the sixth annual follow-up visit and comparison of the SWAN data to the 2002 NHIS CAM use data for the third aim. Our hypotheses emanate from preliminary examination of early data on CAM use in the cohort of midlife women in SWAN. The results of the present analyses will make a valuable contribution, not only to understanding the prevalence of CAM use in midlife women, but also the factors that affect use and the reasons for CAM use in this age group and how these reasons and determinants and types of CAM use vary by race/ethnicity and over the menopausal transition.