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Women's awareness and knowledge of hormone therapy post-Women's Health Initiative

Rigby, Alison J. PhD, MPH, MS, RD1; Ma, Jun MD, PhD,RD2; Stafford, Randall S. MD, PhD2

doi: 10.1097/gme.0b013e3180333a33

Objective: Findings from the Women's Health Initiative (WHI) failed to confirm previous expectations about the net benefits of menopausal hormone therapy and have resulted in reduced use of these medications. The aim of this study was to evaluate women's awareness and knowledge concerning the risks and benefits of hormone therapy.

Design: A nationally representative survey was completed for a sample of 781 women (ages 40-60 y, mean 49 y) drawn from the Knowledge Networks Internet panel 24 months after publication of the first WHI findings, in June 2004. Responses were weighted to reflect the demographics of the US population. The main outcome measures were awareness of WHI and knowledge of its findings. An aggregate score was constructed to assess women's knowledge of the impact of hormone therapy on seven key disease outcomes. Logistic regression determined the independent predictors of (1) WHI awareness and (2) a positive aggregate knowledge score, reflecting appropriate responses about risks and benefits.

Results: Only 29% of women were aware of the WHI results. Only 40% of women had a positive aggregate knowledge score. Aside from awareness of WHI and independent of other factors, knowledge scores were lower for African American women (odds ratio, 0.4; 95% CI: 0.2-0.6) and among women with less education (odds ratio, 0.5; 95% CI: 0.3-0.9). Knowledge was greatest for breast cancer and osteoporosis outcomes and most limited for colorectal cancer and memory loss.

Conclusion: Surveyed women had limited awareness and knowledge of the WHI results, suggesting limited diffusion. Targeting younger, less educated, and African American women is warranted.

An evaluation of women's awareness and knowledge concerning health risks and benefits of hormone therapy, using a nationally representative survey from the Knowledge Networks Internet panel.

From the 1Division of Pediatric Endocrinology and Diabetes, and 2the Program on Prevention Outcomes and Practices, Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA.

Received October 6, 2006; revised and accepted January 3, 2007.

Funding/support: This study was supported by a research grant from GlaxoSmithKline Consumer Healthcare, LP. Dr. Alison J. Rigby was supported by Public Health Service Training Grant no. 5 T32 HL 07034 from the National Heart, Lung, and Blood Institute.

Financial disclosure: None reported.

Address correspondence to: Alison J. Rigby, PhD, MPH, MS, RD, Pediatric Endocrinology and Diabetes, Stanford University School of Medicine, Grant Building, Room S-302, Stanford, CA 94305-5208. E-mail:

©2007The North American Menopause Society